bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early cytokine signatures and clinical phenotypes discriminate persistent from resolving MRSA bacteremia
Authors: Bergersen Kristina V. , Zheng Ying , Rossetti Maura , Ruffin Felicia , Pickering Harry , Parmar Rajesh , Sunga Gemalene , Chan Liana C. , Gjertson David , Fowler Vance G. , Yeaman Michael R. , Reed Elaine F. ,   the MRSA Systems Immunobiology Group, Hoffmann Alexander , Medie Felix , Sharma Batu , Thaden Joshua 
Published: February 2025

Abstract

Background

Staphylococcus aureus bacteremia (SAB) is a prevalent life-threatening infection often caused by methicillin-resistant S. aureus (MRSA). Up to 30% of SAB patients fail to clear infection even with gold-standard anti-MRSA antibiotics. This phenomenon is termed antibiotic-persistent MRSA bacteremia (APMB). The mechanisms driving APMB are complex and involve host phenotypes significantly impacting the immune response. Thus, defining early immune signatures and clinical phenotypes that differentiate APMB from antibiotic resolving (AR)MB could aid therapeutic success.

Methods
We assessed 38 circulating cytokines and chemokines using affinity proteomics in 74 matched pairs of vancomycin-treated SAB cases identified as ARMB or APMB after 5 days of blood culture.

Results
Unsupervised hierarchical clustering segregated APMB from ARMB based on differential levels of IL-10, IL-12p40, IL-13, CCL4, and TGFα. Additionally, CXCL1, CCL22 and IL-17A significantly differed between APMB and ARMB when correlated with diabetes, dialysis, metastatic infection, or cardiac vegetation. Combining immune signatures with these relevant clinical phenotypes sharply increased accuracy of discriminating APMB outcome to 79.1% via logistic regression modeling. Finally, classification-regression tree analysis revealed explicit analyte thresholds associated with APMB outcome at presentation especially in patients with metastatic infection.

Conclusions
Collectively, this study identifies previously unrecognized cytokine and chemokine signatures that distinguish APMB and ARMB at presentation and in the context of host clinical characteristics associated with increased disease severity. Validation of a biomarker signature that accurately predicts outcomes could guide early therapeutic strategies and interventions to reduce risks of persistent SAB that are associated with worsened morbidity and mortality.
Parenting involvement of Thai expectant fathers during the last trimester pregnancy of their spouses exhibiting depressive symptoms: a qualitative study
Authors: Lundberg Pranee C. , Phoosuwan Nitikorn 
Published: February 2025

Abstract

Background
Becoming a father is a challenging process that starts during pregnancy. During the late pregnancy period, depressive symptoms are the most common mental disorders among women. Engaged fatherhood is a strategy for gender equality that is good for the health outcomes of men, their spouses and their children. This study aims to explore the involvement of Thai expectant fathers during the last trimester of their partners’ pregnancy when the mothers exhibit depressive symptoms.

Methods
A qualitative study with semi-structured interviews was conducted by use of an interview guide. All data were transcribed and subjected to content analysis.

Results
Twenty-seven expectant fathers at seven antenatal care clinics of public hospitals in a province of north-eastern Thailand participated. Six categories emerged: Having mixed emotional feelings, Adapting to spouse’s emotional mood swings, Getting into challenges of fatherhood, Taking increased responsibility in the role of father, Receiving social support, and Wishing improvement of maternity care service. The expectant fathers experienced different psychological and physical situations and received support from family members and social networks, but they had not been encouraged to engage in parental education. Some were satisfied with healthcare service and some would like to be more involved.

Conclusions
On the basis of these findings, it is suggested that an intervention program should be developed that aims to engage expectant fathers in maternity health services. This could be done most effectively by starting with men who wish themselves to be involved in the healthcare of their spouses and continuing with men who do not have such wish. Professional support for nurses/midwives should be not only informative but also emotional and practical when needed.
The image of autism in the Polish press 2009–2020 and the role of first-person testimonies
Authors: Wodziński Maciej , Kamińska Natalia , Moskalewicz Marcin 
Published: February 2025

Abstract
This study examines the representation of autism in Polish press discourse from 2009 to 2020 in five major Polish daily newspapers, specifically focusing on the influence of first-person testimonies of autistic individuals. Quantitative discourse analysis was conducted using deductive coding of 1352 press articles concerning ASC. In analyzed press reports, autism was primarily portrayed as a negative and deficit-laden phenomenon that should be addressed by bringing autistic people in line with the neurotypical majority, reinforcing social stereotypes and stigma. Autistic people’s perspective was mostly neglected. However, when autistic people’s voice and first-person perspective was presented, as in the case of 3.7% of the analyzed media, such stereotypical and negative perspectives on ASC significantly changed for the better.
Research outcomes highlight the disparities in autism portrayal, particularly contrasting the deficit-driven narratives with perspectives emerging from the inclusion of first-person narratives. The latter can mitigate harmful stereotypes and promote a more accurate and positive understanding of autism. Treating autistic people as an essential source of information about themselves significantly changes the press image of autism and may indirectly contribute to their quality of life.
Workload in antenatal care before and after implementation of an electronic decision support system: an observed time-motion study of healthcare providers in Nepal
Authors: Radovich Emma , Das Seema , Karki Sulata , Bottomley Christian , McCarthy Ona L. , Shrestha Abha , Penn-Kekana Loveday , Shakya Rajani , Karmacharya Biraj Man , Shrestha Abha , Campbell Oona M. R. , Gon Giorgia 
Published: February 2025

Abstract

Background
Healthcare interventions are shaped by the resources needed to implement them, including staff time. This study, part of a process evaluation, aims to compare time spent on antenatal care (ANC) and related recordkeeping in two rural primary-level health facilities in Nepal, before and after implementation of an electronic decision support system intervention to improve ANC quality that required additional electronic documentation.

Methods
The study is a before-and-after, observational time-motion assessment. Researchers used the WOMBAT (Work Observation Method By Activity Timing) software to observe and record activities performed by auxiliary nurse midwives providing ANC in two rounds of data collection. We summed the observation time (in minutes) spent on activity categories for each day of observation, in each round of data collection. For each auxiliary nurse midwife, we estimated the proportion of total observation time spent on activities and compared these proportions before and after intervention implementation. We also compared the mean minutes per day spent on ANC and recordkeeping in the two rounds.

Results
Six auxiliary nurse midwives were observed over two data collection rounds (41 total observation days). Prior to intervention, providers spent 7% of their workday on ANC and 6% on related recordkeeping, and time spent on these activities did not change after intervention implementation. Only one of the six auxiliary nurse midwives demonstrated a statistically significant increase in time spent on ANC and recordkeeping after implementation. There was considerable day-to-day variation in ANC time, and substantial periods of “non-work” time (on break or not engaged in work-related activity). Non-work time reduced from 42% in the first round to 26% in the second round of data collection.

Conclusions
Time spent on ANC and related recordkeeping was low and did not change after implementation of the electronic decision support system. ANC and recordkeeping time was sensitive to day-to-day fluctuations in numbers of women attending for ANC at these rural facilities, which may have masked the intervention’s effects. However, the large amount of non-work time observed suggests time constraints during the workday were not a major factor inhibiting use of the electronic decision support system.
The people-centered care and inpatients’ perceived experience in China: a nationwide cross-sectional study
Authors: Wang Zhixing , Wang Xueyao , Chiu Herng-Chia , Kong Xiangrong , Li Qingfeng , Ran Xu , Liu Yang , Liang Hailun , Shi Leiyu 
Published: February 2025

Abstract

Background
The concept of People-Centered Care (PCC) is a prominent concept around the world, which is considered as an important concept and practice to promote health equity especially in China. Nevertheless, the association between PCC and the perceived experience of patients remains unclear, particularly from the perspective of the entire nation. This study examined the relationship between PCC and inpatients’ perceived experience in China.

Methods
The study utilized nationwide data collected from 351 healthcare facilities in 31 provinces representing all facility levels and types using proportional odds models. The five attributes of PCC encompass the following categories: continuity of care, information sharing, enhanced access, effectiveness, and respect, each contributing to improving health equity. Inpatients’ perceived experience includes the following factors: inpatients’ satisfaction with the hospitalization, the recognition of the hospital, and the recommendation of the hospital.

Results
Concerning inpatients’ overall satisfaction with the hospitalization, all PCC attributes had a positive effect on satisfaction, especially for inpatients with higher levels of care continuity and respect, contributing to health equity. Inpatients with a higher level of continuity were 3.66 times more likely to ameliorate their level of satisfaction from “very unsatisfied” to “unsatisfied.” Meanwhile, all PCC attributes had significantly positive effects on inpatients’ recognition, with effectiveness and respect showing an even stronger association with health equity. Regarding inpatients’ recommendation measures, all PCC attributes were positively associated, especially with higher levels of care continuity and effectiveness.

Conclusion
People-centered care is positively associated with inpatients’ perceived experience, and enhancing health equity through PCC attributes can further improve this experience. Further reform and practice should focus on the amelioration of continuity of care, promotion of information sharing between medical staff and patients, access and effectiveness of care, and respect for patients, all contributing to health equity.
Fasciitis-panniculitis syndrome with autoantibodies reacting to adipocyte pericellular fibers: a case report
Authors: Uehara Yu , Enya Takuji , Miyazaki Kohei , Hakata Yoshiyuki , Kawahara Sachiyo , Miyazawa Masaaki , Sugimoto Keisuke 
Published: February 2025

Abstract

Background
Fasciitis-panniculitis syndrome (FPS) typically presents with swelling and skin hardening. Its histopathological characteristics include inflammatory cell infiltration and fibrous thickening of the subcutaneous tissue and fascia. Panniculitides in children are rare and only a small number of juvenile FPS cases have been reported. We encountered a case of a 10-year-old boy in which autoantibodies reactive to adipocyte pericellular fibers were detected in relapsing FPS.

Case presentation
The patient developed a high fever and skin swelling with pain and erythema on the right side of his body following an abrasion injury on his right wrist at the age of 5 years, and was suspected of having streptococcal toxic shock-like syndrome, for which he received antimicrobials, immunoglobulin therapy, debridement, and plasma exchange. The same manifestations with similar magnetic resonance imaging (MRI) findings of high signal on short tau inversion recovery showing the spread of inflammation in the fat tissue and fascia was observed twice at the age of 6 years. Serological analyses for conventional autoantibodies, bone marrow aspiration, and whole-exome sequencing examination were non-remarkable. Prednisolone was effective in ameliorating the above putative autoinflammatory syndrome. The patient was admitted at the age of 10 years with similar clinical and MRI findings indicative of recurrence of the same disease. En bloc biopsy from the skin to the fascia showed thickening of collagen fibers, infiltration of inflammatory cells composed mainly of neutrophils and lymphocytes, and necrotizing vasculitis in the fat tissue and fascia. Immunohistochemical staining of the en bloc biopsy sections indicated infiltration of T lymphocytes and macrophages in the perivascular connective tissue and fibrinoid necrosis, supporting the diagnosis of FPS. Induction therapy with prednisolone resulted in a remission. IgG purified from the patient’s serum reacted with pericellular basement membranes in the subcutaneous fat tissue by immunohistochemistry. The patient is currently taking famotidine to prevent relapses and is making good progress in his recovery.

Conclusions
Although pathogenic autoantibodies have not been described in FPS, our results suggest that fat-tissue-reactive autoantibodies may be involved in the pathogenesis of FPS.
Efficacy of atypical antipsychotics in schizophrenia patients: effects of 5-HTR SNPs
Authors: Liu Keying , Zhang Bide , Chen Zhoufangyuan , Chen Fukun , Li Zexu , Gao Yunzhi , Zhao Yuechao , Liu Yihao , Wang Yanlong 
Published: February 2025

Abstract
The 5-hydroxytryptamine receptor (5-HTR) is a key protein responsible for the effects of 5-hydroxytryptamine (5-HT) and an important target for many antipsychotics. 5-HTR has a high degree of genetic polymorphism, and atypical antipsychotics are 5-HTR antagonists widely used in treating schizophrenia. With the increasing development of medical technology, antipsychotics are being updated rapidly, and their efficacy and safety are being optimised. However, owing to the complexity of patients’ genetic polymorphisms and psychiatric disorders, there are still individual differences in clinical efficacy. This article reviews the typing of 5-HTR, a common target of clinical atypical antipsychotics, and the effects of 5-HTR gene single nucleotide polymorphisms (SNPs) on the efficacy of atypical antipsychotics. Specific genotypes of six types of 5-HTR genes are associated with differential responses to atypical antipsychotics, which may help guide the development of individualized clinical treatments for patients with schizophrenia.
Evaluation of collaborative oral health care planning between older adults and personnel from public dental care and municipal care organizations: a study protocol for a cluster-randomized controlled study in Sweden
Authors: Persson Kylén Jessica , Björns Sara , Hägglin Catharina , Bellander Lisa , Brattbäck Atzori Annsofi , Persson Kylén Sven , Baar Ann-Christine , Wijk Helle 
Published: February 2025

Abstract

Background

Patient participation is key in person-centred care, emphasizing individual choices in treatment. Oral health, integral to overall well-being, is sometimes a neglected part of health. This intervention introduces a novel approach to strengthen person-centred care in homecare settings, employing collaborative, interprofessional teamwork and shared documentation across care organizations. This protocol outlines the design of a cluster-randomized controlled trial (RCT) in Sweden, comparing traditional oral assessments with an interorganizational, team-based oral health care planning model facilitated by a shared digital platform for documentation. The overall aim is to evaluate a person-centred interprofessional and interorganizational model for oral health care planning supported by a digital platform to enable healthy ageing.

Methods/design
The intervention, co-designed with older adults, academic institutions, healthcare providers in public dental care, and municipal organizations, will undergo ethical approval. The RCT will randomize older adults, dental hygienists (DHs) and nursing assistants (NAs) into two groups. The intervention group will attend a two-day workshop on a person-centred, three-step team-based model, while the control group will continue using standard procedures. Thereafter, the three-step collaborative model will be compared to standard procedures. Primary outcomes will be measured using the Revised Oral Assessment Guide (ROAG) and the General Oral Health Assessment Index (GOHAI). Secondary outcomes include health economic evaluations, participation rates and quality of care assessments. Qualitative studies from theoretical perspectives of change and learning based on interviews with key stakeholders will be conducted in both the test and control groups.

Discussion
Taking a co-produced approach where theory and practice shape the research iteratively, a person-centred health care planning model supported by a shared digital platform for home settings is evaluated. Anticipated outcomes include improved oral assessments and a deeper understanding of effective person-centred care practices. The co-produced approach of the intervention is also expected to further develop knowledge regarding co-production within domains of healthy ageing from an oral health perspective. As such, the intervention shapes and fosters co-produced person-centred care and healthy ageing.

Trial registration
ClinicalTrials.gov NCT06310798. Registered on 13 March 2024.
Elevated levels of PAI-1 precede the occurrence of type 2 diabetes mellitus
Authors: Hernestål-Boman Jenny , Öhman Tina , Jansson Jan-Håkan , Lind Marcus M. , Rolandsson Olov , Bergdahl Ingvar A. , Johansson Lars 
Published: February 2025

Abstract

Aims
Plasminogen activator inhibitor-1 (PAI-1) is the main inhibitor of the fibrinolytic system and is mainly secreted from adipose tissue. It is associated with cardiovascular disease and has also been considered a possible early risk marker for type 2 diabetes. Here, we present the results of a large prospective study investigating PAI-1 levels in relation to incident type 2 diabetes mellitus.

Methods
We conducted a prospective incident case-referent study within the Västerbotten Intervention Programme (VIP). Data on cardiovascular risk factors, fasting plasma glucose (FPG) and 2-hour plasma glucose (2-hPG) were collected at baseline health examination 1990–2005. Blood samples were collected and stored for future analyses. Participants were followed and 484 cases developed type 2 diabetes. Referents without type 2 diabetes were matched for sex, age, and year of participation, n = 484. Baseline plasma samples were analysed for PAI-1. Subgroup analysis was performed for 201 cases and 201 matched referents with normal baseline glucose levels (FPG < 6.1 and 2hPG < 8.9 mmol/L).

Results
Elevated baseline levels of PAI-1 were associated with incident type 2 diabetes after adjustments for BMI, family history of diabetes, smoking status, hypertension, FPG and 2hPG (PAI-1; OR = 1.87, 95% CI: 1.06–3.29). A similar result was shown in the subgroup analysis with 201 participants who had normal glucose levels at time of the health examination (PAI-1; OR = 2.68, 95% CI: 1.03–6.95).

Conclusions
Elevated PAI-1 levels in non-diabetic persons precede the manifestation of type 2 diabetes and can be detected before an elevation of FPG or 2-hPG is observed.
Sufficiency-driven business models for rare earth recycling: integrating stakeholder collaboration and customer discovery for sustainable innovation
Authors: Chinwego Chinenye , Garcia Rosanna , Sehar Daniel McArthur , MacGregor Evan , Tate Steven , Savage Kenneth , Zuber Thaddaeus , Sseruwagi Benjamin , Dietrich Daniel , Opoku Emmanuel , Smith David , Powell Adam , Mishra Brajendra 
Published: February 2025

Abstract
This paper explores the development of a collaborative and customer-centric business model for sustainable innovation in rare earth magnet recycling. Rare earth elements have become crucial to various electronics and renewable energy systems. Due to their finite nature and the supply risk they pose as they are available in a few countries, recycling these magnets is becoming increasingly important as demand increases. This study highlights the importance of developing business models that prioritize resource sufficiency, economic viability and environmental conservation. It emphasizes customer discovery, a critical component in understanding market needs and consumer behavior. Through detailed case studies as part of the NSF I-Corps program, this paper presents evidence from over 130 stakeholder interviews, completed with individuals from rare earth magnet companies, rare earth magnet recycling companies, National laboratories, metal alloy companies, and metal recycling companies. These case studies highlight best practices, challenges, and lessons learned, providing a comprehensive blueprint for other businesses to follow. In addition, this paper explores policy implications, advocating for regulatory frameworks that support sustainable practices and incentivize recycling initiatives. Ultimately, this research aims to contribute to the circular economy by demonstrating how sufficiency-driven business models can lead to sustainable growth and resilience in the rare earth recycling industry. By integrating stakeholder collaboration and customer discovery, businesses can innovate effectively, ensuring the sustainability of both their operations and the environment.
Harnessing precision nutrition to individualize weight restoration in anorexia nervosa
Authors: Rodriguez Isabel , Huckins Laura M. , Bulik Cynthia M. , Xu Jiayi , Igudesman Daria 
Published: February 2025

Abstract
Anorexia nervosa (AN) is a severe psychiatric disorder for which effective treatment and sustained recovery are contingent upon successful weight restoration, yet the efficacy of existing treatments is suboptimal. This narrative review considers the potential of precision nutrition for tailoring dietary interventions to individual characteristics to enhance acute and longer-term weight outcomes in AN. We review key factors that drive variation in nutritional requirements, including energy expenditure, fecal energy loss, the gut microbiota, genetic factors, and psychiatric comorbidities. Although scientific evidence supporting precision nutrition in AN is limited, preliminary findings suggest that individualized nutrition therapies, particularly those considering duration of illness and the gut microbiota, may augment weight gain. Some patients may benefit from microbiota-directed dietary plans that focus on restoring microbial diversity, keystone taxa, or functions that promote energy absorption, which could enhance weight restoration—although stronger evidence is needed to support this approach. Furthermore, accounting for psychiatric comorbidities such as depression and anxiety as well as genetic factors influencing metabolism may help refine nutrition prescriptions improving upon existing energy estimation equations, which were not developed for patients with AN. Given the reliance on large sample sizes, costly data collection, and the need for computationally intensive artificial intelligence algorithms to assimilate deep phenotypes into personalized interventions, we highlight practical considerations related to the implementation of precision nutrition approaches in clinical practice. More research is needed to identify which factors, including metabolic profiles, genetic markers, demographics, and habitual lifestyle behaviors, are most critical to target for individualizing weight restoration, and whether personalized recommendations can be practicably applied to improve and sustain patient recovery from this debilitating disorder with high relapse and mortality rates.