bluuebunny/crossref_metadata_2025_split huggingface dataset:
A mixed-methods examination of the acceptability of, CareMOBI, a dementia-focused mhealth app, among primary care providers
Authors: Ali Zuha , Zhong Jie , Sadarangani Tina R 
Published: November 2024

Background CareMOBI (mhealth for Organization to Bolster Interconnectedness) is a user-centered mobile application that supports secure communication between adult day health centers, primary care providers, and family caregivers. The aim of this study was to examine the acceptability of CareMOBI in the primary care setting and identify factors contributing to the likelihood of adoption among primary care providers. Methods We used a mixed-methods concurrent triangulation design. We, first, collected quantitative data using the Technology Acceptance Model questionnaire. Follow-up interview questions allowed participants to elaborate on their experience interacting with CareMOBI. We developed an informational matrix based on major themes within the Technology Acceptance Model (ease of use, value in clinical care, fit within existing workflows, and likelihood of adoption) in which qualitative data were embedded and compared. Results Our sample included 10 primary care providers. Participants rated CareMOBI high in ease of use ( M = 6.71 out of 7), value in clinical care ( M = 6.79), and likelihood of adoption ( M = 6.71). They found specific functions of CareMOBI helpful, including the summary of health progress and the patient profile. In contrast, participants reported the lowest score for the fit of CareMOBI within existing workflows ( M = 5.52). Qualitative feedback attributed this score to concerns over the lack of interoperability between CareMOBI in its current form and electronic health record systems used in the primary care setting. Conclusion Providers found CareMOBI valuable and easy to use, and there was a high likelihood of eventual adoption. However, apprehensions regarding workflow and electronic health records integration arose, which the team will have to consider as they move forward to the next phase of the application's development.
Biometric Changes Up to 2 Years After Hip Arthroscopy in National Collegiate Athletic Association Division I Athletes
Authors: Steiner Quinn , Walczak Brian E. , Sanfilippo Jennifer , Joachim Mikel R. , Haraldsdottir Kristin , Watson Andrew M. 
Published: November 2024

Background: Patients who undergo hip arthroscopy for femoroacetabular impingement (FAI) require lower extremity immobilization for an extended period of time. Periods of immobilization combined with surgery have been associated with decreased muscle mass and bone mineral density (BMD). Purpose/Hypothesis: The purpose of this study was to characterize postoperative body composition and BMD changes after arthroscopy for FAI. It was hypothesized that both lean mass and BMD would decrease postoperatively and then normalize over time. Study Design: Case series; Level of evidence, 4. Methods: This was a retrospective review of 23 National Collegiate Athletic Association Division I athletes who underwent hip arthroscopy between 2017 and 2019 and had a dual-energy x-ray absorptiometry scan preoperatively and at 3, 6, 12, or 24 months postoperatively. Linear mixed-effects models were used to compare pre- with postoperative lean and fat mass values for the total body and total leg (both operative and nonoperative sides) as well as trunk, pelvic, and spinal BMD. For total-leg, femur, and femoral BMD, linear mixed-effects models were used to evaluate the influence of time, side (operative vs nonoperative), and their interaction on each outcome measure. Results: Regarding pelvic BMD, compared with baseline (mean, 1.41 g/cm2 [95% CI, 1.33-1.49]), significant decreases were seen at postoperative 3 months (mean, 1.36 g/cm2 [95% CI, 1.28-1.45 g/cm2]; P < .001) and 6 months (mean, 1.39 g/cm2 [95% CI, 1.27-1.52 g/cm2]; P < .01) but not at 12 months (mean, 1.42 g/cm2 [95% CI, 1.33-1.51 g/cm2]; P = .319). Total-leg BMD for the operative side increased significantly from baseline (mean, 1.52 g/cm2 [95% CI, 1.43-1.61 g/cm2]) to ≥2 years postoperatively (mean, 1.56 g/cm2 [95% CI, 1.47-1.65 g/cm2]) ( P = .005). Combined leg fat mass was increased from baseline (mean, 6427 g [95% CI, 4855-7999 g]) to ≥2 years (mean, 11645 g [95% CI, 7845-15,446 g]) ( P < .01). There were no significant differences in total-body fat or lean mass or combined-leg lean mass. Conclusion: In this patient population, a postoperative decrease in pelvic BMD that resolved by 12 months and an increase in total-leg BMD on the operative side at ≥2 years were observed. While hip arthroscopy for FAI may have significant benefits for long-term body composition and bone mass, clinicians should be aware of the potential implications of decreased bone mass for up to 12 months postoperatively.
Clinical Practice Competence and Its Associated Factors Among Generic Nursing Students Learning at Public Universities: A Cross-Sectional Study
Authors: Ahmedin Lencho , Birhanu Adamu , Mekuria Mulugeta , Ahmed Nesredin , Yassin Aminu Mohammed , Keneni Mulualem , Wondimneh Fenta , Tesi Seid , Legesse Henok 
Published: November 2024

Introduction One of the global strategic direction and policy priorities in 2021 through 2025 is preservice education of nurses. Even though, quality education is the foundation to produce competent health workers, ensuring the competence of the health professionals is as imperative as maximizing their number. This study aims to fill the literature gap among nursing students in public universities. Objectives The purpose of this study is to assess the prevalence of clinical practice competence and its associated factors among graduating BSc nursing students in public universities from July 15 to August 15, 2022. Methods An institutional-based cross-sectional study was carried out in randomly selected public universities in eastern Ethiopia. A total of 143 students were systematically selected to fill out the questionnaire through multistage sampling. Frequency, mean, and standard deviations of independent variables and proportion of clinical practice competence were analyzed using descriptive statistics. AOR with a p-value of <.05 was used to declare a significant association. Results The study found that 69 (53.1%) of study participants were clinically competent. Students with good clinical instructors [AOR: 3.79, 95%CI: 1.56–9.21], learning in a conducive clinical setting [AOR: 3.59, 95%CI: 1.26–10.23] and assessed using measurable methods [AOR: 3.77, 95%CI: 1.53–9.30] were significantly associated. Conclusion In this study, almost one in two of the students was clinically incompetent. Respective stakeholders could enhance students’ competence by monitoring and evaluating students during clinical practice, creating favorable learning settings, and developing comprehensive assessment methods.
Medial Patellofemoral Ligament Reconstruction With Concomitant Tibial Tubercle Osteotomy
Authors: Garcia Jose Rafael , Allende Felicitas , Pallone Lucas , Yanke Adam B. , Chahla Jorge 
Published: November 2024

Background: Patellar instability, often associated with medial patellofemoral ligament rupture, is prevalent in adolescents. Risk factors include trochlear dysplasia, patella alta, abnormal patellar tilt, and increased tibial tubercle to trochlear groove (TT-TG) distance. Indication: A variety of surgical options are available for addressing patellar instability, and the selection of each technique should be tailored to the unique pathoanatomy of each patient. Medial patellofemoral ligament reconstruction (MPFLR) is indicated for patients with patellar instability, and tibial tubercle osteotomy (TTO) is indicated for patients with a TT-TG >20 mm. Technique Description: An anterior midline incision is performed to expose the patella, patellar tendon, and tibial tubercle. Diagnostic arthroscopy is performed to assess patellar engagement and cartilage integrity, followed by the TTO. Three guidewires are placed with 15° of obliquity, to guide a 6-cm osteotomy, from medial to lateral and from proximal to distal. A distal cortical hinge must be left intact. A 15-mm medial resection of the tibial tubercle is performed to avoid protrusion against the skin, which is followed by medialization of the tubercle and fixation with K-wires until dynamic testing ensures proper alignment and definitive fixation is achieved with cannulated headless screws. A lateral retinacular lengthening is performed to balance patellar forces. MPFLR is executed using a semitendinosus allograft. The graft is anchored to the patella and drawn through a surgically created plane to the medial femoral condyle. The femoral tunnel is created under fluoroscopy guidance, and the graft is then passed and secured. Graft tension and patellar mobility are adjusted according to dynamic testing. Once patellar stability is achieved and maintained through range of motion, the graft is then fixed. Results: Patients can expect improved clinical outcomes with a high return-to-sports rate following both isolated MPFLR and concomitant TTO. The combination of MPFLR + TTO significantly reduces revision rate, compared to isolated MPFLR in patients with increased TT-TG distance, and enhances postoperative patellofemoral tracking. Discussion/Conclusions: MPFLR + TTO improves patellofemoral tracking and corrects patellar instability, substantially improving postoperative outcomes compared to MPFLR alone. Patients with patellar instability and an increased TT-TG may be effectively treated with MPFLR + TTO. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Increased levels of versican and insulin-like growth factor 1 in peritumoral mammary adipose tissue are related to aggressiveness in estrogen receptor-positive breast cancer
Authors: Mirra Paola , Parascandolo Alessia , Marino Graziella , D’Alterio Federica , Zinna Lorenza , Desiderio Antonella , Patitucci Giuseppe , Vita Giulia Anna Carmen , Condelli Valentina , Russi Sabino , D’Andrea Francesco , Beguinot Francesco , Miele Claudia , Formisano Pietro , D’Esposito Vittoria 
Published: November 2024

AbstractThe adipose tissue (AT) surrounding breast cancer (BC) plays a pivotal role in cancer progression and represents an optimal source for new biomarker discovery. The aim of this work was to investigate whether specific AT factors may have prognostic value in estrogen receptor-positive (ER+) BC. Proteoglycan Versican (VCAN), Insulin-like Growth Factor 1 (IGF1), Reticulon 4B (RTN4), chemokines CCL5 (also known as RANTES) and interleukin 8 (IL-8) are expressed in AT and may play important roles in BC progression. Peritumoral AT and tumoral biopsies were obtained from patients with ER+ BC (N = 23). AT specimens were collected also from healthy women (N = 17; CTRL-AT). The analysis of gene expression by qPCR revealed significantly higher mRNA levels of VCAN, IGF1, RTN4, and CCL5 in BC-AT compared to the CTRL-AT, and no difference in IL-8 mRNA levels. VCAN positively correlated with patient Body Mass Index (BMI) in BC-AT, while not in CTRL-AT. Moreover, VCAN and IGF1 positively correlated with RTN4 and negatively with CCL5. Interestingly, VCAN correlated with tumoral Ki67, while IGF1 with tumoral OCT4 that, in turn, correlated with tumoral Ki67 and patient BMI. Thus, peritumoral AT content of VCAN, and IGF1 are related to BC proliferation and aggressiveness.
Peri-injury symptomatology as predictors of brain computed tomography (CT) scan abnormalities in mild traumatic brain injury (mTBI)
Authors: Vasista Sihi , Saint-Fleur Josue , Kapoor Neera , Ganti Latha 
Published: November 2024

Abstract
Objective
This study aimed to identify predictors of brain CT abnormalities in patients who sustained a mild traumatic brain injury (mTBI).

Methods
Retrospective observational cohort of adult patients with mTBI (Glasgow Coma Score 13–15) that occurred within the preceding 24 h.

Results
2548 (91%) of the cohort had a brain CT and 698 (27%) demonstrated abnormal findings. The most frequently observed CT abnormalities were bleeding (638, 25%) and fractures (190, 7.4%). Multivariate logistic regression analysis revealed several significant predictors associated with the presence of brain CT abnormalities including older age [P < 0.0001], male sex [P < 0.0001], loss of consciousness [P = 0.0041], associated vomiting [P = 0.0011], alteration of consciousness (AOC) [P = 0102], and GCS score [P < 0.0001]. This was a robust model with an R² of 14.2%.

Conclusion
In this retrospective analysis, older age, male sex, the presence of loss of consciousness or alteration in consciousness, lower GCS score, and associated vomiting were found to be significant predictors of having an abnormal brain CT. These findings highlight the importance of considering these factors when determining the necessity of brain CT scans in patients with mTBI and suggest that existing clinical decision rules may be limited. These findings may also help to inform clinical decision rules. Early identification of individuals at a higher risk of CT abnormalities may assist in appropriate management and allocation of healthcare resources.
Is environmental risk assessment possible with the alternatives to acute fish toxicity test? Case study with pharmaceuticals
Authors: Mlnaříková Marie , Pípal Marek , Bláhová Lucie , Bláha Luděk 
Published: November 2024

Abstract
Background
Acute fish toxicity test (AFT) is one of the cornerstones of environmental risk assessment (ERA) of chemicals for the aquatic environment. Despite many efforts to find an alternative able to fully replace the test, there is still lasting pressure from stakeholders for AFT results.

Results
Here, we present the results of a case study with eight pharmaceuticals from various pharmaceutical groups with different levels of expected toxicity to fish. Selected compounds were tested in two validated alternative tests—fish embryo toxicity test with zebrafish (Danio rerio) (zFET) and in vitro RTgill-W1 assay according to their corresponding OECD guidelines TG 236 and TG 249, respectively. Data for AFT were collected from PubMed and ECOTOX knowledgebase databases, and acute toxicity to fish was further predicted in silico by the ECOSAR program. Predicted environmental risks (risk quotients, RQ, calculated using the exposure data from NORMAN) from both zFET and RTgill-W1 well correlated with the average RQs based on AFT LC50s. The strongest and most significant correlation was observed while comparing the AFT results with the median of combined alternative methods (zFET, RTgill-W1, ECOSAR).

Conclusions
This proposed approach combining experimental data with modeling could serve as a reliable tool for predictions of environmental risks promoting the 3R alternatives to acute fish toxicity testing.
Evaluation of seminal plasma levels of vaspin and visfatin in infertile males with elevated sperm DNA fragmentation index: a comparative study
Authors: Amer Medhat Kamel , Youssef Neveen Ahmed , GamalEl Din Sameh Fayek , Saied Nada Gamal , Ahmed Merna Ayman , Raef Ahmad , Ragab Ahmed 
Published: November 2024

Abstract
Background
Sperm DNA fragmentation (SDF) can significantly impact male fertility, especially in cases where there is a substantial level of DNA damage. We aimed in the current study to assess seminal plasma (SP) levels of vaspin and visfatin in infertile men with an elevated SDF index (SDFI ≥ 30%) compared to infertile males with a normal SDFI (SDFI < 30%).

Results
Groups with good and medium DNA integrity exhibited significantly higher total motile sperm count and sperm motility in comparison to the group with poor DNA integrity. Significant negative correlations were noticed between SDF index (SDFI) and numerous semen parameters. Similarly, a significant negative correlation was observed between SDFI and SP vaspin. On the other hand, a significant positive correlation was found between SDFI and abnormal forms percentage. A statistically significant negative correlation was identified SP vaspin with age (r = -0.305, P = 0.006) and infertility duration (r = -0.263, P = 0.019). Statistically significant negative correlation was also identified between SP visfatin and abnormal forms percentage (r = -0.239, P = 0.034). The receiver operating characterisitic curve for predicting poor DNA integrity (SDFI ≥ 30%) revealed fair discriminative power for SP vaspin, with a cutoff value of < 0.55 ng/ml. It demonstrated a sensitivity of 58.8% and a specificity of 64.5% (area under the cureve (AUC) 0.685, p = 0.008). Meanwhile, SP visfatin had little discriminative power (AUC 0.562, p = 0.408). Finally, the results of a linear regression analysis indicated that sperm motility and SP vaspin were significant independent predictors of poor DNA integrity (SDFI ≥ 30%). The analysis was done with a 95% confidence interval and showed upper and lower bounds of -0.302 and -0.623, and -1.362 and -16.101, p < 0.001, p = 0.021, respectively.

Conclusion
SP Level of vaspin had shown promise as potential biomarkers for sperm DNA integrity. However, vaspin appeared to have greater specificity than visfatin in this point. Future studies are required to validate these findings, evaluate the role of SP vaspin in maintaining sperm DNA integrity, and investigate the potential relationship between SP adipocytokines and other clinical-demographic variables.
Comparative genomics of Plasmodium yoelii nigeriensis N67 and N67C: genome-wide polymorphisms, differential gene expression, and drug resistance
Authors: Wu Jian , Oguz Cihan , Teklemichael Awet Alem , Xu Fangzheng , Stadler Rachel V , Lucky Amuza Byaruhanga , Liu Shengfa , Kaneko Osamu , Lack Justin , Su Xin-zhuan 
Published: November 2024

Abstract
Background
The study of rodent malaria parasites has significantly advanced our understanding of malaria parasite biology and host responses to parasite infections. There are four well-characterized rodent malaria parasite species (Plasmodium yoelii, P. chabaudi, P. berghei, and P. vinckei). Each species also has multiple strains that cause different disease phenotypes. P. yoelii nigeriensis N67C and N67, two isogenic parasites, are particularly intriguing as they differ in virulence and incite different immune responses in mice. The genome of the N67 parasite has been assembled recently, but not that of N67C. This study used PacBio HiFi sequencing data to assemble the N67C genome, compared the two genomes, and performed RNA sequencing to identify polymorphisms and differentially expressed genes (DEGs).

Results
The assembled N67C parasite genome consisted of 16 scaffolds and three contigs of approximately 22.5 Mb with 100% and 96.6% completeness based on well-characterized single-copy orthologs specific to the Apicomplexa phylum and the Plasmodium genus, respectively. A comparison between the annotated N67C and N67 genomes revealed 133 single nucleotide polymorphisms (SNPs) and 75 indels. Among the polymorphic sites, an S (N67) to N (N67C) amino acid substitution at position 114 (S114N) in the dihydrofolate reductase-thymidylate synthase (DHFR-TS) confers resistance to pyrimethamine in mice. Additionally, 60 differentially expressed single-copy genes (DEGs) were detected after comparing mRNA levels between the two parasites. Starting with the predicted and annotated 5,681 N67C and 5,749 N67 genes, we identified 4,641 orthogroups that included at least one gene from the four P. yoelii parasites (N67, N67C, 17X, and YM), whereas 758 orthogroups showed subspecies or strain-specific patterns.

Conclusion
The identification of polymorphic sites between the N67 and N67C genomes, along with the detection of the DEGs, may provide crucial insights into the variations in parasite drug responses and disease severity between these two isogenic parasites. The functional characterization of these genetic differences and candidate genes will deepen our understanding of disease mechanisms and pave the way for developing more effective control measures against malaria.
Effects of aspirin and omega-3 fatty acids on composite and subdomain scores from the NEI-VFQ-25 questionnaire: the ASCEND-Eye randomized controlled trial
Authors: Sammons Emily L. , Buck Georgina , Bowman Louise J. , Stevens William M. , Hammami Imen , Parish Sarah , Armitage Jane ,   on behalf of the ASCEND Study Collaborative Group
Published: November 2024

Abstract
Background
The double-blind, 2 × 2 factorial design, placebo-controlled ASCEND randomized trial compared the effects of 100 mg aspirin daily and, separately, 1 g omega-3 fatty acids (FAs) daily on the primary prevention of cardiovascular disease in 15,480 UK adults with diabetes. We report the effects of these randomized treatment allocations on scores derived from the National Eye Institute’s Visual Function Questionnaire-25 (NEI-VFQ-25) in a subset of participants involved in the ASCEND-Eye sub-study.

Methods
Ordinal data from the NEI-VFQ-25 were analyzed using proportional odds regression methods. A common odds ratio with a 95% confidence interval was used to interpret the average effect size of randomization to each study treatment on composite and subdomain scores from the questionnaire.

Results
Neither randomization to aspirin nor omega-3 FAs for 7.5 years significantly affected composite or subdomain scores from the NEI-VFQ-25.

Conclusion
Applying the NEI-VFQ-25 in ASCEND-Eye represents one of the largest surveys of vision-targeted health-related quality of life in people with diabetes. Further observational analyses of these data are planned, to identify the clinical and demographic characteristics associated with lower composite and subdomain scores in a diabetic population.

Trial registration
Eudract No. 2004–000991-15; Multicentre Research Ethics Committee Ref No. 03/8/087 (29th December 2003); ClinicalTrials.gov No. NCT00135226 (24th August 2005); ISRCTN No. ISRCTN60635500 (1st September 2005).
A randomized controlled trial on the effect of cranial electrotherapy stimulation on depression, anxiety, and craving in addicted male patients undergoing methadone maintenance treatment
Authors: Ravari Homa Baghaei , Kheradmand Ali , Ghorbani Mahdi , Shamsi Alireza , Khosravi Mehdi 
Published: November 2024

Abstract
Background
Addicted patients undergoing methadone maintenance treatment are prone to several complications and the risk of relapse.

Objective
The present study aims to investigate the effect of cranial electrotherapy stimulation on depression, anxiety, and craving in addicted male people undergoing methadone maintenance treatment.

Methods
This randomized controlled trial study was conducted on 60 male patients referred to Persia addiction treatment center between 2021 and 2022. Patients were randomly divided into two equal treatment and placebo groups. The treatment group received cranial electrotherapy stimulation intervention for 48 sessions of 30 min. Depression and anxiety were evaluated using the Hamilton questionnaire before and after the intervention, and the level of craving was also evaluated with the Federdi 2008 questionnaire.

Results
Comparing the level of depression and anxiety before and after the intervention in both treatment and placebo groups did not show any significant difference (p < 0.05). Craving after the intervention was significantly different in both groups and was lower in the treatment group compared to the placebo group (33.43 versus 42.17, p = 0.004). In the placebo group, the level of anxiety and depression, and in the treatment group, the level of depression, anxiety and craving for consumption decreased significantly after the intervention compared to before the intervention (p < 0.05).

Conclusion
Cranial electrotherapy stimulation did not have a significant effect on reducing the level of depression and anxiety of patients, but it is effective in the reduction of craving in addicted people undergoing methadone maintenance treatment.

Trial registration
This randomized clinical trial was registered on 2022/5/13 with clinical trial code of IRCT20210523051367N1.