bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health-related quality of life in outpatients with substance dependence: evolution over time and associated factors
Authors: Simirea Melexima , Baumann Cédric , Bisch Michael , Rousseau Hélène , Patrizio Paolo Di , Viennet Sarah , Bourion-Bédès Stéphanie 
Published: October 2021

Abstract
Background

Health-related quality of life (HRQoL) is an important element of patient care and clinical research. The aim of this study was to describe HRQoL changes and identify associated factors during a 6-month follow-up among outpatients starting care for alcohol or opioid dependence.
Methods

HRQoL was measured at baseline and 3 and 6 months later using the SF-12. Data on sociodemographics, clinical characteristics and patient levels of anxiety and depression were collected using the Hospital Anxiety and Depression Scale (HADS). Repeated-measures analyses were performed to assess factors associated with global HRQoL differences and evolution of HRQoL in both physical and mental scores (PCS and MCS, respectively).
Results

The mean PCS and MCS scores were initially low at 45.4 (SD=8.6) and 36.0 (SD=10.9), respectively. The improvement in HRQoL was rapid in the first 3-month period, then slower and was even maintained over the subsequent 3-month period. Being employed (p=0.012), having no comorbidities (p=0.0144) and no depression (p=0.0041) were associated with significant differences in the average PCS scores at the 3 time points. Patients who had lower overall HRQoL MCS scores on average were those for whom a medication was initiated (p= 0.0086), as was the case for patients with anxiety (p=0.0001) and depression (p=0.0009). Patients with depression at baseline were also those for whom a significantly greater increase in MCS during the 6 months of follow-up was observed.
Conclusion

Our findings highlight the importance of screening early psychological distress and considering other factors associated with HRQoL changes after the first 3-month period in SUD outpatients.
Effect of End-of-Life Nursing Education on the Knowledge and Performance of Nurses in the Intensive Care Unit: A Quasi-Experimental, Randomized, Controlled Trial
Authors: Shushtari Sima Sadat Ghaemizade , Molavynejad Shahram , Adineh Mohammad , Savaie Mohsen , Sharhani Asaad 
Published: October 2021

Abstract
Background

End-of-life care education is required for nurses to acquire the clinical competence necessary for the improvement of the quality of end-of-life nursing care. The aim of this study was to determine the effect of nursing care education based on End-of-Life Nursing Education Consortium (ELNEC) on the knowledge and performance of nurses working in the intensive care unit (ICU).
Materials and Methods

This quasi-experimental, randomized, controlled trial was conducted with a pretest-posttest design. From among nurses working in the ICU of Golestan and Imam Khomeini hospitals in Ahvaz, Iran, 80 nurses were selected bsed on the inclusion criteria. They were randomly assigned to the intervention and control groups (40 people in each group) using a table of random numbers. Data were collected using a demographic characteristics form, the ELNEC Knowledge Assessment Test (ELNEC-KAT), ‎and the Program in Palliative Care Education and Practice Questionnaire (German Revised Version; PCEP-GR‎).
Results

A significant difference was observed between the study groups in terms of the average knowledge score in all 9 modules including nursing care, pain management and control, disease symptom management, ethical/legal issues, culture, communication with the patient and his/her family, loss and grief, death, and quality of life (QOL) (P < 0.001). Moreover, the average performance score of nurses in the fields of preparation for providing palliative care, self-assessment of ability to communicate with dying patients and their relatives, self-assessment of knowledge and skills in palliative care increased significantly in the intervention group compared to the control group (P < 0.001).
Conclusions

End-of-life nursing education is recommended as an effective method for promoting knowledge, attitude, performance, and clinical competence among all nurses involved in end-of-life care.
Prevention of 90-day Detox Readmission for Opioid Use Disorder by a Community-based Life-changing Individualized Medically Assisted Evidence-based Treatment (C.L.I.M.B.) Program: a Quasi-experimental Design
Authors: Luo Zhehui , Roychoudhury Canopy , LMSW William S. Pompos , DiMaria James , Robinette Cynthia M. , Gore Purva H , Roychoudhury Rohon , Beecroft William 
Published: October 2021

Abstract
Background: Evidence for community-based detox readmission prevention strategies for opioid use disorder (OUD) is scant. We evaluated a pilot program designed to provide individualized and structured treatment plan, including addressing prolonged withdrawal symptoms, family/systems assessment, contingency management, and medically assisted treatment. Methods: A non-randomized quasi-experimental design was used to compare the pilot sites (treatment) and comparison sites before and after the program started, i.e., a simple difference-in-differences (DID) strategy. Adults 18 years and older who meet the Diagnostic and Statistical Manual of Mental Disorders version 5 criteria for OUD and had a detox admission at any facility in two study periods between 5/2018 and 12/2019 are included. Readmission in 90-days after an inpatient detox was the primary outcome. Multiple statistical estimation methods were used to adjust for potential confounding factors between treatment and control groups.Results: A total of 2,320 unique patients with 2,443 index detox admission in the pre- and post-periods were compared. The C.L.I.M.B. patients had higher readmission compared with the controls in the pre-period (unadjusted readmission rates16.4% vs. 10.0%) and similar rates in the post-period (11.8% vs. 10.1%). All DID estimates were not statistically significant (adjusted estimates ranged from 6.0 to 9.2 percentage points difference favoring the C.L.I.M.B. program). Conclusions: While not statistically significant, wrap-around services reduced detox readmission. It may be that the added services helped to inform people that inpatient detox is not necessary for OUD and withdrawal can be managed with a structured treatment plan.
Lactate Metabolism Regulates Tumour Growth and Progression in Glioblastoma
Authors: Longhitano Lucia , Vicario Nunzio , Tibullo Daniele , Giallongo Cesarina , Broggi Giuseppe , Caltabiano Rosario , Barbagallo Giuseppe Maria Vincenzo , Baghini Marta , Rosa Michelino Di , Parenti Rosalba , Giordano Antonio , Mione Maria Caterina , Volti Giovanni Li 
Published: October 2021

Abstract
Background. Tumor microenvironment (TME) plays a pivotal role in establishing malignancy and it is associated with high glycolytic metabolism and increased lactate production accumulating in TME through monocarboxylate transporters (MCTs). Several lines of evidence suggest that lactate also serves as a signalling molecule through its receptor HCAR1thus functioning as a paracrine and autocrine signalling molecule in TME. The aim of the present study was to investigate the role of lactate in glioblastoma (GBM) progression and metabolic reprogramming in an in vitro and in vivo model.Methods. Cell proliferation, migration and clonogenicity assay were performed in vitro on three different human GBM cell lines. Protein expression of MCT1, MCT4 and pharmacological lactate receptor (GPR81) were evaluated both in vitro and in a zebrafish GBM in vivo model. These results were further validated in patient-derived GBM biopsies.Results. Our results showed that lactate significantly increased cell proliferation, migration and colony formation capacity of GBM cells, both in vitro and in vivo. We also showed that lactate increased MCT1 and HCAR1 expression. Moreover, lactate modulated epithelial-mesenchymal transition protein markers E-Cadherin and β-Catenin. Interestingly, lactate induced mitochondrial mass and OXPHOS gene suggesting an improved mitochondrial fitness. Similar effects were observed after treatment with 3,5-Dihydroxybenzoic acid, a known agonist of GPR81. Consistently, GBM zebrafish model exhibited an altered metabolism and increased expression of MCT1 and HCAR1 leading to high levels of extracellular lactate and thus supporting tumor cell proliferation. Our data from human GBM biopsies also showed that in high proliferative GBM biopsies, Ki67 positive cells expressed significantly higher levels of MCT1 compared to low proliferative GBM cells.Conclusions. Our data suggest that lactate favours proliferation of neighbourhood cells by cooperating with their glycolytic metabolism, sensing and removing extracellular lactate. In particular, lactate and its transporter and receptor play a major role in GBM proliferation and migration thus representing a potential target to develop new strategies to counteract tumor progression and recurrencies.
Reprogramming of arachidonate metabolism confers drug resistance to glioblastoma through Enhancing Mitochondrial Activity in Fatty Acid Oxidation
Authors: Tsai Yu-Ting , Lo Wei-Lun , Chen Pin-Yuan , Ko Chiung-Yuan , Kao Tzu-Jen , Yang Wen-Bing , Chang Kwang-Yu , Hung Chia-Yang , Kikkawa Ushio , Chang Wen-Chang , Hsu Tsung-I 
Published: October 2021

Abstract
Background

Sp1 is involved in the recurrence of glioblastoma (GBM) due to the acquirement of resistance to temozolomide (TMZ). Particularly, the role of Sp1 in metabolic reprogramming for drug resistance remains unknown.
Methods

RNA-Seq and mass spectrometry were used to analyze gene expression and metabolites amounts in paired GBM specimens (primary vs. recurrent) and in paired GBM cells (sensitive vs. resistant). ω-3/6 fatty acid and arachidonic acid (AA) metabolism in GBM patients were analyzed by targeted metabolome. Mitochondrial functions were determined by Seahorse XF Mito Stress Test, RNA-Seq, metabolome and substrate utilization for producing ATP. Therapeutic options targeting prostaglandin (PG) E2 in TMZ-resistant GBM were validated in vitro and in vivo.
Results

Among the metabolic pathways, Sp1 increased the prostaglandin-endoperoxide synthase 2 expression and PGE2 production in TMZ-resistant GBM. Mitochondrial genes and metabolites were obviously increased by PGE2, and these characteristics were required for developing resistance in GBM cells. For inducing TMZ resistance, PGE2 activated mitochondrial functions, including fatty acid β-oxidation (FAO) and tricarboxylic acid (TCA) cycle progression, through PGE2 receptors, E-type prostanoid (EP)1 and EP3. Additionally, EP1 antagonist ONO-8713 inhibited the survival of TMZ-resistant GBM synergistically with TMZ.
Conclusion

Sp1-regulated PGE2 production activates FAO and TCA cycle in mitochondria, through EP1 and EP3 receptors, resulting in TMZ resistance in GBM. These results will provide us a new strategy to attenuate drug resistance or to re-sensitize recurred GBM.
Summer Regional Climate Simulations Over Tibetan Plateau at Gray-Zone and Convection-Permitting Scale
Authors: Ma Mengnan , Ou Tinghai , Liu Dongqing , Wang Shuyu , Fang Juan , Tang Jianping 
Published: October 2021

Abstract
The Tibetan Plateau (TP) is often referred to as ‘the Third Pole’ and plays an essential role in influencing the global climate. However, it remains challenging for most global and regional models to realistically simulate the characteristics of long-period climate over the TP. In this study, two Weather Research and Forecasting model (WRF) experiments using the regional climate simulation method of spectral nudging with gray-zone (GZ9) and convection-permitting (CP3) resolution are conducted for summer from 2009 to 2019. The surface air temperature (T2m) and precipitation are evaluated against in-situ observations and the Global Satellite Mapping of Precipitation (GSMaP) dataset. The results show that both experiments can successfully capture the spatial pattern and daily variation of T2m and precipitation, though cold bias for temperature and dry bias for precipitation exist especially over the regions south of 35ºN. Compared to GZ9, CP3 reduces the cold and dry bias over the southern TP. In addition, analysis of the diurnal variation of precipitation shows that both experiments simulate the advanced occurrence time of maximum precipitation by about 3 hours over the eastern TP but postpone the occurrence time of maximum precipitation over the central and western TP. Both experiments simulate a bimodal structure of the diurnal cycle of precipitation amount (PA). Further investigation reveals that GZ9 has more low-level clouds and prevents shortwave radiation from reaching the surface during daytime, leading to lower maximum surface air temperature (Tmax) in GZ9, while CP3 has more low-level clouds over the southeastern TP and preventing the outgoing longwave radiation and compensating the heat loss during nighttime, resulting in higher minimum surface air temperature (Tmin) in CP3. Besides, more water vapor over the southeastern TP results in more precipitation and thus reduced dry bias in CP3 over the southeastern TP. Moreover, the current study also indicates that gray-zone scale simulations can perform as good as convection-permitting simulations by carefully choosing the right parameterization schemes.
PIK3CA Mutation Correlates With mTOR Pathway Expression But Not Clinical and Pathological Features in Fibro-Adipose Vascular Anomaly (FAVA)
Authors: Hori Yumiko , Hirose Katsutoshi , Ozeki Michio , Hata Kenji , Motooka Daisuke , Tahara Shinichiro , Matsui Takahiro , Kohara Masaharu , Higashihara Hiroki , Ono Yusuke , Tanaka Kaishu , Toyosawa Satoru , Morii Eiichi 
Published: October 2021

Abstract
BackgroundFibro-adipose vascular anomaly (FAVA) is a rare and new entity of vascular anomaly. Activating mutations in the phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) gene were identified at a frequency of 62.5% in FAVA cases. The PIK3CA mutations excessively activate mammalian target of rapamycin (mTOR) pathway, which promotes angiogenesis and lymphangiogenesis, implying that PIK3CA mutations may act as drivers of FAVAs. This study investigated the correlations between PIK3CA mutational status, clinicopathological features and immunohistochemical expression of the mTOR pathway in a series of FAVA.MethodsWe retrospectively evaluated the clinical and pathological findings of five FAVA cases. We performed next-generation sequencing (NGS) with a custom panel of genes associated with the mTOR pathway and genes responsible for other vascular anomalies, direct sequencing and immunohistochemical analysis of the mTOR pathway.ResultsTwo PIK3CA-mutation cases and three PIK3CA-wild-type (wt) cases exhibited similar typical clinical features of FAVA. Histological analysis revealed venous malformation, lymphatic malformation, nerves containing enlarged abnormal vessels and fibrofatty tissue were observed regardless of PIK3CA mutational status. In contrast to clinical and histological findings, the immunohistochemical expression of activated AKT and mTOR that are upstream of the mTOR pathway was detected in abnormal vessels of PIK3CA-mutation cases but not in those of PIK3CA-wt cases. However, activated eukaryotic translation initiation factor 4E-binding protein 1 (4EBP1) and ribosomal protein S6 kinase 1 (S6K1), both of which are downstream effectors of the mTOR pathway, were expressed in abnormal vessels of both PIK3CA-mutation and PIK3CA-wt cases. Furthermore, targeting NGS did not find any common genetic mutations involved in the mTOR pathway among PIK3CA-wt cases.ConclusionThere was no significant association between the presence of PIK3CA mutations and the clinicopathological features of FAVA, suggesting that the PIK3CA gene is not necessarily involved in the onset of FAVA. FAVAs lacking PIK3CA mutations would be caused by other gene mutations that activate 4EBP1 and S6K1.
Competing at the Cybathlon Championship for Athletes With Disabilities: Long-Term Motor Imagery Brain-Computer Interface Training of a Tetraplegic Cybathlete
Authors: Korik Attila , McCreadie Karl , McShane Niall , Du Bois Naomi , Khodadadzadeh Massoud , Stow Jacqui , McElligott Jacinta , Carroll Áine , Coyle Damien 
Published: October 2021

Abstract
Background: The brain-computer interface (BCI) race at the Cybathlon championship for athletes with disabilities challenges teams (BCI researchers, developers and pilots with spinal cord injury) to control an avatar on a virtual racetrack without movement. Here we describe the training regime and results of the Ulster University BCI Team pilot who is tetraplegic and has trained to use an electroencephalography (EEG)-based BCI intermittently over 10 years, to compete in three Cybathlon events. Methods: A multi-class, multiple binary classifier framework was used to decode three kinesthetically imagined movements (motor imagery) (left (L) and right (R) arm and feet (F)) as well as relax state (X). Three games paradigms were used for training i.e., NeuroSensi, Triad, and Cybathlon: BrainDriver. An evaluation of the pilot’s performance is presented for two Cybathlon competition training periods – spanning 20 sessions over 5 weeks prior to the 2019 competition, and 25 sessions over 5 weeks in the run up to the 2020 competition.Results: Having participated in BCI training in 2009 and competed in Cybathlon 2016, the experienced pilot achieved high two-class accuracy on all class pairs when training began in 2019 (decoding accuracy >90%, resulting in efficient NeuroSensi and Triad game control). The BrainDriver performance (i.e., Cybathlon race completion time) improved significantly during the training period, leading up to the competition day, ranging from 274s - 156s (255±24s to 191±14s mean±std), over 17 days (10 sessions) in 2019, and from 230s - 168s (214±14s to 181±4s), over 18 days (13 sessions) in 2020. However, on both competition occasions, towards the race date, the performance deteriorated significantly.Conclusions: The training regime and framework applied were highly effective in achieving competitive race completion times. The BCI framework did not cope with significant deviation in electroencephalography (EEG) observed in the sessions occurring shortly before and during the race day. Stress, arousal level and fatigue, associated with the competition challenge and performance pressure resulting in cognitive state changes, were likely contributing factors to the nonstationary effects that resulted in the BCI and pilot achieving suboptimal performance on race day. Trial registration: not registered
Mental Health Stigma at Primary Health Care Centres in Lebanon: Qualitative Study
Authors: Hana Racha Abi , Arnous Maguy , Heim Eva , Aeschlimann Anaïs , Koschorke Mirja , Hamadeh Randa S. , Thornicroft Graham , Kohrt Brandon A. , Sijbrandij Marit , Cuijpers Pim , Chammay Rabih El 
Published: October 2021

Abstract
Background Mental health related stigma is a global public health concern and is considered a major barrier to seeking care. In this study, we explored the role of stigma as a barrier to scaling up mental health services in primary health care (PHC) centres in Lebanon. We focused on the experiences of PHC workers, while providing services to patients with mental disorders, and the perceptions of stigma or discrimination among individuals with mental illness and their families. This study was part of a larger multinational stigma reduction programme, called INDIGO-PRIMARY.Method Semi-structured qualitative interviews (n=46) were carried out, with policy makers (n=3), PHC management (n=4), PHC staff (n=24), service users and family members (n=15). The topic guides explored knowledge, implicit and explicit attitudes of staff, challenges of providing treatment, and patient outcomes including experiences of stigma. All interviews were coded using NVivo and analysed using a thematic coding framework.Results Results were analysed at five stigma-related layers: from structural stigma at the system level, down to provider-based stigma at PHC level, community level stigma, family stigma and self-stigma. Interestingly at the PHC level, stigma reporting differed among staff according to a power gradient. Service users described positive experiences in PHC. Nurses and social workers did not explicitly report incidents of stigma or discrimination but describing patients with mental health disorders as violent or uncooperative, underscored internalized negative views on mental health. GPs and directors were more outspoken than nurses regarding the challenges faced when dealing with mental health patients. Nevertheless, mental health professionals reported that things have been getting increasingly better over recent years.Conclusions This qualitative study revealed that stigma was still a major concern that affects patients with mental disorders and provided a deeper understanding on what should be done to decrease stigma at PHC centres; first addressing structural stigma by revising laws, second shaping interpersonal stigma, third commitment of PHC management to deliver high quality mental health integrated services, and fourth addressing intrapersonal stigma by building public empathy.
Lard-Blended Vegetable Oil Diet Alleviates Metabolic Syndrome in Mice
Authors: Yan Sisi , Qu Jianyu , Liu Xiangyan , Liu Sha , Zeng Yu , Zhou Huijuan , Matias Froilan Bernard , Wen Lixin , Wang Ji 
Published: October 2021

Abstract
Background: Our previous work has suggested that the balance fatty acid diet, blending lard with soybean oil, could reduce adipose tissue accumulation by decreasing adipogenesis and lipogenesis while increasing the hydrolysis of triglycerides. The aim of present study is to investigate whether the fat reducing function of balanced fatty acid diet extended to sunflower oil, and explore its effects on liver lipids metabolism and insulin resistance.Methods: 50 mice were divided into 5 groups, fed with lard, sunflower oil, soybean oil, mixture of lard and sunflower oil, and mixture of lard and soybean oil for 12 weeks separately.Results: Results showed that a mixture of lard and vegetable oil (sunflower oil and soybean oil), particularly a mixture of lard and soybean oil decreased body weight, body fat rate, liver triglyceride level compared to lard, sunflower oil, and soybean oil, a mixed oil also decreased serum triglyceride and free fatty acid levels compared to lard diet. Further analysis indicated that activation of the AMPK pathway contributes to these observed phenotypes, and co-upregulated of glucagon and GLP-1 in mice fed with mixture of lard and soybean oil may contribute to improved lipids metabolism. Conclusion: Moderate lard intake—blended lard with vegetable oil especially soybean oil—has the potential to alleviate metabolic syndrome via activating AMPK pathway and co-upregulated of glucagon and GLP-1.