bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Hand Edema on Weaning From Mechanical Ventilation in ICU Patients: A Single Center Nested Case‐Control Study
Authors: Wu Dingye , Heng Junfeng , Liang Fengming , Zhou Tao , Wang Qiuhui , Xu Hongyang 
Published: February 2025

Objective: To investigate the impact of hand edema on weaning from mechanical ventilation among ICU patients.Methods: A nested case‐control study was conducted, collecting data from mechanically ventilated patients admitted to the ICU of Wuxi People’s Hospital from October 1, 2023, to January 31, 2024. Patients were monitored for the occurrence of hand edema within the first 7 days of ICU stay and their weaning outcomes were recorded to analyze the impact of hand edema on weaning success.Results: The study included 124 patients, 97 successfully weaned while 27 failed. The failed weaning group had higher ages (70.8 ± 10.5 years), SOFA scores (17.7 ± 3.1), and levels of hand edema (Grade 0 in 6 patients, Grade 1 in 9, Grade 2 in 6, Grade 3 in 3, and Grade 4 in 3) compared with the successful weaning group (ages 61.1 ± 9.8 years, SOFA scores 14.3 ± 3.1, hand edema levels: Grade 0 in 78, Grade 1 in 15, Grade 2 in 3, Grade 3 in 1, and Grade 4 in 0). Multivariable binary logistic regression analysis indicated that the level of hand edema is an independent risk factor for weaning failure within 1 week in ICU patients on mechanical ventilation (OR = 3.209, 95% CI: 1.641–6.274, and p < 0.05).Conclusion: The occurrence of hand edema in ICU patients on mechanical ventilation increases the risk of weaning failure.
Semen Quality Measures in Hookah and Cigarette Smokers Compared to Nonsmokers
Authors: Hamadneh Jehan , Al-Zenati Aseel A. , Banihani Saleem A. 
Published: February 2025

Background: The relationship between smoking and human health is a well‐researched and continuously evolving field. The impact of smoking on semen quality, and consequently on male fertility, has also been explored, though most studies have primarily focused on cigarette smoking rather than hookah smoking.Objective: In this study, we aimed to investigate and compare the effects of hookah and cigarette smoking on semen parameters in a sample of Jordanian males.Methods: A total of 558 participants were prospectively recruited, including 300 cigarette smokers, 95 hookah smokers, and 163 nonsmokers (control). Semen analysis was performed approximately 1 h after ejaculation following the World Health Organization guidelines (2021).Results: Interestingly, semen volume was significantly decreased in hookah smokers (p = 0.0097) but not in cigarette smokers when compared to the control group. No significant differences were observed in semen volume, progressive sperm motility, total motility, sperm count, sperm morphology (p = 0.2714, p = 0.8752, p = 0.6671, p = 8614, and p = 0.9261, respectively), and sperm vitality between hookah and cigarette smokers. Furthermore, except for semen volume, these semen parameters were not statistically different in both tested groups when compared to the control group.Conclusions: Hookah smokers demonstrated lower semen volume compared to the control group. Additionally, no significant differences were found in sperm count, percentage of sperm motility, normal forms of sperm, and sperm vitality between hookah and cigarette smokers or between these groups and the control group.
High Glucose Contribution to the TCA Cycle Is a Feature of Aggressive Non–Small Cell Lung Cancer in Patients
Authors: Cai Ling , Hammond Nia G. , Tasdogan Alpaslan , Alsamraae Massar , Yang Chendong , Cameron Robert B. , Quan Peiran , Solmonson Ashley , Gu Wen , Pachnis Panayotis , Kaur Mayher , Chang Brianna K. , Zhou Qin , Hensley Christopher T. , Do Quyen N. , Martins Nascentes Melo Luiza , Ubellacker Jessalyn M. , Kaushik Akash , Clare Maia G. , Alcazar Isabel N. , Kurylowicz Katarzyna , Marcuccilli Joseph D. , Allies Gabriele , Kutritz Andrea , Klode Joachim , Ramesh Vijayashree , Rogers Thomas J. , Rao Aparna D. , Crentsil Hannah E. , Li Hong , Brister Fang , McDaniel Phyllis , Xu Xiaohong , Evers Bret M. , Zacharias Lauren G. , Sudderth Jessica , Xu Jian , Mathews Thomas P. , Oliver Dwight , Minna John D. , Waters John , Morrison Sean J. , Kernstine Kemp H. , Faubert Brandon , DeBerardinis Ralph J. 
Published: February 2025

Abstract
In patients with non–small cell lung cancer (NSCLC), the relationship between tumor metabolism and clinical outcomes is unknown. Here, 13C-labeled nutrients were intraoperatively infused into more than 90 patients with surgically resectable pulmonary lesions, and metabolic properties of resected tumors were correlated with survival. In NSCLCs infused with 13C-glucose, high 13C enrichment in tricarboxylic acid (TCA) cycle intermediates conferred a HR of 3.8 for early death, typically with metastasis. To test whether these features reflect requirements for metastasis, we generated patient-derived xenografts that spontaneously metastasize to multiple organs. Treatment with an electron transport chain (ETC) inhibitor reduced glucose-derived TCA cycle labeling but did not suppress subcutaneous tumor growth. However, ETC blockade reduced the abundance of circulating cancer cells and suppressed xenograft metastatic burden in distant organs. Our data demonstrate that isotope labeling can identify metabolic properties associated with metastasis in patients and that blocking the ETC suppresses metastasis in mice.

Significance:
Intraoperative 13C-glucose infusions in patients with NSCLC show that tumors with high labeling of TCA cycle intermediates progress rapidly, resulting in metastasis and early death. Blocking this pathway suppresses metastasis of human NSCLC cells in mice.
β-Hydroxybutyrate Facilitates Postinfarction Cardiac Repair via Targeting PHD2
Authors: Wang Cheng , Xu Wenjing , Jiang Shushu , Wu Yichen , Shu Jiangchen , Gao Xinyuan , Huang Kai 
Published: February 2025

BACKGROUND:
Acute myocardial infarction (MI) remains one of the major causes of death worldwide, and innovative treatment strategies for MI represent a major challenge in cardiovascular medicine. Caloric restriction (CR) is the most potent nonpharmacological intervention known to prevent age-related disorders and extend lifespan. CR reduces glycolysis and elevates ketone body metabolism. However, whether and how CR or ketone body prevents the progression of MI remains poorly defined.

METHODS:
Mice treated with CR and β-hydroxybutyrate (β-OHB) underwent MI induced by ligation of the left anterior descending coronary artery. Cardiac function was assessed by echocardiographic measurements. Histological analysis, fluorescence-activated cell sorting, and immunofluorescence were used to assess myocardial neovascularization and macrophage filtration. The interaction and modification of β-OHB on PHD2 were analyzed by molecular docking, cellular thermal shift assay, liquid chromatography with tandem mass spectrometry, and coimmunoprecipitation. Macrophage-specific PHD2 K239R and K385R knock-in mice were used to determine the functional significance of β-OHB/PHD2 axis in vivo.

RESULTS:
Twelve weeks of CR markedly rescued postinfarction cardiac function by enhancing neovascularization. CR significantly increased circulating and cardiac ketone bodies, including β-OHB and acetoacetate. We identified β-OHB but not acetoacetate selectively targeted macrophages to stimulate VEGF (vascular endothelial growth factor) production in the peri-infarct area to promote neovascularization and cardiac repair. Mechanistically, β-OHB binds to and induces lysine β-hydroxybutyrylation of PHD2 at lysines 239 and 385, thus blocking its function in the hydroxylation of HIF-1α (hypoxia-inducible factor 1α) and resulting in enhanced HIF1α-dependent VEGF transcription and secretion. More importantly, specific PHD2 lys239 and lys385 mutations in macrophages abolished the preventive effects of exogenous β-OHB on MI in mice.

CONCLUSIONS:
These data reveal a novel regulation of lysine β-hydroxybutyrylation on PHD2 and demonstrate a promising and therapeutic role for β-OHB/PHD2 in effectively accelerating neovascularization and preserving heart function after cardiac ischemia.
Evaluation of anti-CD38 monoclonal antibody-based immunotherapy in multiple myeloma with renal insufficiency: a systematic review and meta-analysis
Authors: Bai Hexiang , Zhang Chunlan , Zhao Ailin , Tang Wenjiao , Zhang Li 
Published: February 2025

Background: Renal impairment is one of the common characteristics of multiple myeloma (MM) and makes management of MM more complicated. Even though monoclonal antibodies targeting CD38 have wildly succeeded in treating MM, the addition of anti-CD38 monoclonal antibodies to standard therapy to treat MM patients with renal insufficiency is still poorly studied. Objectives: This study aims to evaluate whether using anti-CD38 monoclonal antibody-based immunotherapy would improve the prognosis of MM patients with renal insufficiency. Design: This is a systematic review and meta-analysis. Data sources and methods: We searched Scopus, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid Embase, and Web of Science Core Collection for randomized controlled trials that enrolled patients with MM who received CD38-targeting monoclonal antibody regimens and reported the efficacy and survival of MM with renal insufficiency. We then performed a meta-analysis to estimate the efficacy of adding anti-CD38 monoclonal antibodies to backbone regimens in MM with renal insufficiency. Results: In 7594 studies screened, 12 phase III trials were eligible, including 5 trials for newly diagnosed MM (NDMM; 3194 patients; 1261 with renal insufficiency) and 7 trials for relapsed refractory MM (RRMM; 2657 patients; 648 with renal insufficiency). Among NDMM patients with renal insufficiency, the addition of anti-CD38 monoclonal antibody to backbone regimens was associated with improved progression-free survival (PFS; pooled HR, 0.50; 95% CI, 0.38–0.67; p < 0.001), with little evidence of heterogeneity (Cochran Q, p = 0.19; I2 = 34.7%). Similar results were seen among RRMM patients with renal insufficiency (pooled HR, 0.46; 95% CI, 0.37–0.57; p < 0.001), with no evidence of heterogeneity (Cochran Q, p = 0.89; I2 = 0%). Similarly, the addition of anti-CD38 monoclonal antibody in RRMM among patients with renal insufficiency was associated with improved overall survival (OS; pooled HR, 0.70; 95% CI, 0.57–0.88; p = 0.002), with no significant heterogeneity (Cochran Q, p = 0.69; I2 = 0%). Conclusion: This meta-analysis suggests that the addition of anti-CD38 monoclonal antibodies benefits PFS in both NDMM and RRMM with renal insufficiency and OS in RRMM patients with renal insufficiency.
Profiling antimalarial drug-resistant haplotypes in Pfcrt, Pfmdr1, Pfdhps and Pfdhfr genes in Plasmodium falciparum causing malaria in the Central Region of Ghana: a multicentre cross-sectional study
Authors: Dakorah Mavis Puopelle , Aninagyei Enoch , Attoh Juliana , Adzakpah Godwin , Tukwarlba Isaac , Acheampong Desmond Omane 
Published: February 2025

Background: The proliferation of Plasmodium parasites resistant to antimalarial drugs poses a serious threat to human life and remains an obstacle to managing and eradicating Plasmodium falciparum. The surveillance of molecular markers has become necessary to monitor the spread of resistant haplotypes and discover emerging mutations. Objective: This molecular epidemiological study aimed to evaluate the prevalence of known mutations in the drug resistance genes Pfcrt, Pfmdr1, Pfdhfr and Pfdhps in the Central Region of Ghana. Design: A multi-centre cross-sectional study. Methods: This prospective study utilised dried blood spots from individuals with P. falciparum-infection from five districts in the Central Region of Ghana. Selective Whole Genome Amplification (sWGA) and Single Nucleotide Polymorphisms (SNPs) in P. falciparum chloroquine transporter genes ( Pfcrt), P. falciparum multidrug resistance 1 ( Pfmdr1), P. falciparum dihydropteroate synthase ( Pfdhps) and P. falciparum dihydrofolate reductase ( Pfdhfr) were analysed. Results: Whole genome sequencing was carried out on 522 samples. Of these, 409 (78%) samples were successfully sequenced. Six (6) of the sequenced samples were of co-infection of other parasite species with P. falciparum and excluded from the analysis. Analysis of the Pfcrt gene revealed 0.5% were CVIET (C72, V73, M74I, N75E, K76T) while the Pfcrt CVMNK (C72, V73, M74, N75, K76) wild-type haplotypes were 97% with (2.5%) (CV[M/I][N/E][K/T]) being mixed haplotypes. In the Pfmdr1 gene, monoclonal haplotypes; NFD (N86, Y184F, D1246) and YFN (N86Y, Y184F, D1246N) occurred at 44% and 9.8%, respectively, whereas mixed- haplotypes (N[Y/F]D and [N/Y][Y/F]D) were 23.5% and 0.3%, respectively. Combined Pfdhfr/ Pfdhps genes yielded about 88% Pfdhfr IRNI (N51I, C59R, S108N, I164) +  Pfdhps A437G haplotypes (conferring partial resistance to Sulphadoxine-Pyrimethamine (SP)) while 9% of the parasites had Pfhdfr IRNI +  Pfdhps A437G + K540E haplotypes (conferring full resistance to SP). The wild-type haplotype, Pfdhfr (N51, C59, S108, I164) and Pfdhps (S436, A437, K540, A581, A613) was not observed. Conclusion: The findings show a low prevalence of CVIET and relatively higher rates for Pfmdr1 NFD and parasites with Pfdhfr IRNI (N51I, C59R, S108N, I164) +  Pfdhps A437G haplotypes. These observations advocate for enhanced surveillance which is inimical to malaria management in an endemic area.
Developing intervention fidelity strategies for a behaviour change intervention delivered in primary care dental practices: the RETURN fidelity strategy
Authors: Lowers Victoria , Young B. , Harris R. V. 
Published: February 2025

Abstract

Background
Behaviour change interventions delivered in real-world settings could be vulnerable to threats to internal and external validity if methodological considerations are overlooked. The primary dental care setting is a difficult environment within which to deliver research protocols presenting unique challenges for robust scientific research delivery. Intervention fidelity strategies are an important mechanism to improve the scientific rigor of such studies. Feasibility studies provide a vital opportunity to refine and optimise research processes and implementation strategies before embarking on larger scale projects. This paper sets out the development of a comprehensive intervention fidelity strategy guided by The National Institutes of Health Behavior Change Consortium.(BCC) recommendations.

Method
Using observations (53 h) and qualitative interviews (17 patient interviews and 2 staff interviews) conducted during the delivery of the RETURN feasibility study (InteRventions to rEduce inequaliTies in the Uptake of Routine deNtal care), an intervention fidelity strategy was developed for use in the RETURN main trial.

Results
A comprehensive intervention fidelity strategy was developed, structured around the five domains of the BCC’s recommendations (design, training, delivery, receipt, enactment) and attending to the goals pertaining to each of those domains. This paper sets out the fidelity strategy implemented in the RETURN main trial.

Implications and conclusions
The RETURN fidelity strategy was influenced by the unique research environment the primary dental care setting presents. The strategy could serve as a blueprint to other researchers conducting research in similar settings. It is also intended that this strategy is read alongside the RETURN results upon their publication.

Trial registration
ISRCTN10853330, registered: 07/10/2019.
Virtual reality cricothyrotomy – a tool in medical emergency education throughout various disciplines
Authors: Burkhardt Valentin , Vallette Marianne , Speck Iva , Flayyih Omar , Huber Christine , Widder Angela , Wunderlich Robert , Everad Friederike , Offergeld Christian , Albrecht Tobias 
Published: February 2025

Abstract

Objectives
A cricothyrotomy represents an emergency procedure that may be considered a last option for securing the airway. While fortunately rare, it is important to note that such invasive procedures must be mastered if they are to be used. Therefore, regular training is essential to gain routine. The aim of the present study was to investigate whether professional groups with different levels of experience with the procedure succeed in learning the procedure with a virtual reality trainer.

Materials and methods
In a multicenter approach, 146 employees with four different professional backgrounds—otorhinolaryngologists, anesthesiologists, emergency physicians and certified nurses—were included in the study. The participants were required to complete a virtual reality (VR) cricothyrotomy scenario in three consecutive runs, and the time required and errors in the procedure were recorded. The training experience was subsequently evaluated subjectively using a questionnaire.

Results
The study included 146 participants with an average age of 33 years and an average of 5 years of professional experience. The majority of participants (74%) reported an improvement in the speed of the procedure and in the procedural steps (87%). These subjective improvements were confirmed objectively by the time required for completion of the procedure and the points achieved. Gaming experience had a significant effect on both the score (p = 0.023) and procedure time (p = 0.039), whereas age and medical specialization did not. Real-life experience with cricothyrotomy had no significant effect on performance in VR.

Conclusion
Virtual reality provides an effective method for training healthcare professionals in cricothyrotomy, regardless of their specialty or prior experience. The participants showed significant improvements in both the speed and accuracy of the procedure after training, regardless of their prior experience or medical background. Further research is necessary to assess the benefits of VR simulation for training cricothyrotomy in real-world procedures.

Trial registration
DRKS00031736, registered on the 20th of April 2023.
Competency-based education and training for Community Health Workers: a scoping review
Authors: Sultan Marium A. , Miller Emily , Tikkanen Roosa Sofia , Singh Shalini , Kullu Arpana , Cometto Giorgio , Fitzpatrick Siobhan , Ajuebor Onyema , Gillon Nicholas , Edward Anbrasi , Moleman Youri P. , Pandya Shivani , Park Inyeong , Shen Jung Yu , Yu Yefei , Perry Henry , Scott Kerry , Closser Svea 
Published: February 2025

Abstract

Background
Community Health Workers (CHWs) play a critical role in supporting the delivery of health services globally. Competency-based learning programs can improve the transfer of learning to practice. This scoping review aims to characterize the published literature on competency-based education as an instructional and curricular strategy in community health worker training programs. We conducted a scoping review of the literature to identify how, by who, and in what ways CHWs are trained using competency-based education; and to characterize the extent of available evidence, as well as the gaps in that evidence.

Methods
We conducted a review of the peer-reviewed literature on CHW competency-based education and training published between January 2010 to March 2023, drawing from four databases: EMBASE, OVID Medline, Web of Science, and CINAHL. We followed the PRISMA guidelines for scoping reviews. A total of 713 articles were reviewed and 236 were included for extraction based on the inclusion and exclusion criteria. Due to methodological heterogeneity, results were analyzed and synthesized only through a descriptive approach.

Results
The literature on competency-based CHW education and training is most voluminous in high income contexts, primarily the USA. Overall, the included studies described very small-scale training interventions. Study types included observational (qualitative, quantitative, mixed methods, case studies) intervention or experimental studies, systematic or scoping reviews, and literature reviews. The most common practice area included was ‘promotive and preventive services’, whereas ‘personal safety’ was the rarest.
Learning programs tailored to CHWs with low-literacy, content tailored to local cultural contexts, and curricula that were co-designed with CHWs were identified in the literature as effective strategies for converting learning to practice.
Information on institutional support for CHWs was not provided in most of the articles reviewed. While the focus of our review was on education and training and not broader supports for CHWs, we still found it notable that training was usually discussed in isolation from other related supportive factors, including professionalization and career progression.

Conclusions
We found considerable academic interest in utilizing competency-based education to support CHWs and improve their work, yet this exploration was largely limited to smaller, ad hoc programs, in high income settings.
Learning programs should be tailored to the realities and practice requirements of CHWs. Further work should illuminate the extent to which the design and delivery of education and training activities lead to acquiring and maintaining the requisite competencies.
Sex differences of neutrophil to high-density lipoprotein cholesterol ratio in predicting the severity of coronary lesions in acute coronary syndrome patients
Authors: Wang Chuntian , Shang Kun , Cao Lina , Kuang Jiangying , Ning Xiang , Chen Huiqiang 
Published: February 2025

Abstract

Background
The neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) is closely related to the occurrence and severeness of coronary stenosis in subjects with acute coronary syndrome (ACS). Men have higher NHR levels than women. The study was designed to examine the usefulness of NHR for predicting severe coronary stenosis in male and female ACS subjects.

Methods
We enrolled 165 ACS patients (105 males and 60 females) who underwent coronary angiography. Clinical parameters; fasting glucose, creatinine, and uric acid levels; lipid profiles; and routine blood indices were measured. The NHR was computed by dividing the neutrophil numbers by the concentration of high-density lipoprotein cholesterol. Coronary stenosis severity was assessed using the Gensini score (GS). A GS˃41 points was regarded as a high GS.

Results
The NHR was clearly greater in male ACS individuals than in their female counterparts (P = 0.001). The NHR was positively linked to the GS (r = 0.330, P = 0.001) in men, whereas there was no association between NHR and the GS in women (r=-0.0.032, P = 0.805). Univariate logistic regression analyses indicated that the NHR predicted a high GS in male ACS patients but not in their female counterparts. Multivariate logistic regression analyses indicated that a high NHR was an independent marker of severe coronary lesions in men (P = 0.001) but not in women (P = 0.274). The areas under the receiver operating characteristic curve of the NHR for the prediction of severe atherosclerosis were 0.681 (P = 0.001) and 0.560 (P = 0.431) in male and female subjects, respectively. An NHR value > 3.99 had a specificity and a sensitivity of 68% and 64%, respectively, for forecasting severe atherosclerosis in male subjects.

Conclusions
The NHR could be utilised to independently predict the severeness of coronary lesions in male ACS subjects but not in their female counterparts. Therefore, the NHR should be used with caution when screening female ACS patients for severe coronary restrictions.