bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary Dickkopf‐3 as a Potential Marker for Estimated Glomerular Filtration Rate Decline in Patients With Heart Failure
Authors: Pieper Dennis , Sandek Anja , Schäfer Ann‐Kathrin , Dihazi Hassan , Dihazi Gry Helene , Leha Andreas , Zeisberg Michael , Lüders Stephan , Koziolek Michael , Wallbach Manuel 
Published: November 2024

Background
Patients with chronic heart failure (HF) show an increased risk for the occurrence of chronic kidney disease and cardiorenal syndrome. Urinary Dickkopf‐3 (uDKK3), a stress‐induced, tubular profibrotic glycoprotein, may be elevated in HF as early as in New York Heart Association class I HF and may indicate subsequent decline in estimated glomerular filtration rate (eGFR).

Methods and Results

uDKK3 levels in patients with HF and controls were measured by enzyme‐linked immunosorbent assay. eGFR was determined up to 5 years in HF. Change in eGFR was assessed with respect to baseline uDKK3 using (mixed‐effect) linear and logistic regression models. A total of 488 patients with chronic HF and 45 control patients were included. Patients with HF showed higher median uDKK3 levels than controls (259.6 pg/mg creatinine [interquartile range (IQR), 119.2–509.4 pg/mg creatinine] versus 107.5 pg/mg creatinine [IQR, 60.5–181.2 pg/mg creatinine],
P
<0.001). Regression models demonstrated a significant association between log uDKK3 and the decline in eGFR during a median of 13 months (IQR, 12–59 months) (estimated higher eGFR loss, 0.8039 mL/min per 1.73 m
2
/year [95% CI, 0.002–1.606 mL/min per 1.73 m
2
/year],
P
=0.049; odds ratio, 1.345 [95% CI, 1.049–1.741],
P
=0.021). uDKK3 levels ≥354 pg/mg creatinine were associated with a significantly higher risk for eGFR decline at 1‐year follow‐up (estimated higher eGFR loss, 4.538 mL/min per 1.73 m
2
[95% CI, 1.482–9.593 mL/min per 1.73 m
2
]),
P
=0.004). Even patients with HF without chronic kidney disease (n=334) had higher uDKK3 levels compared with controls (233.4 [IQR, 109.0–436.9 pg/mg creatinine] versus 107.5 [IQR, 60.5–181.2 pg/mg creatinine],
P
<0.001).

Conclusions
The present findings indicate that uDKK3 is a promising prognostic biomarker for subsequent eGFR decline in patients with HF, irrespective of the presence of chronic kidney disease and even in the early stages of HF. This potential allows for early intervention to mitigate the deterioration of kidney function. Further investigation is warranted to validate its clinical utility.
Multimodal Data‐Driven Prognostic Model for Predicting Long‐Term Prognosis in Patients With Ischemic Cardiomyopathy and Heart Failure With Preserved Ejection Fraction After Coronary Artery Bypass Grafting: A Multicenter Cohort Study
Authors: Wang Jun , Wang Yijun , Duan Shoupeng , Xu Li , Xu Yanan , Yin Wenyuan , Yang Yi , Wu Bing , Liu Jinjun 
Published: November 2024

Background
Limited data from the literature are available to assess the efficacy of coronary artery bypass grafting in patients with ischemic cardiomyopathy and heart failure with preserved ejection fraction. Therefore, our objective was to use machine learning techniques integrating clinical features, biomarker data, and echocardiography data to enhance comprehension and risk stratification in patients diagnosed with ischemic cardiomyopathy and heart failure with preserved ejection fraction who have undergone coronary artery bypass grafting surgery.

Methods and Results
For this study, 294 patients with ischemic cardiomyopathy and heart failure with preserved ejection fraction who underwent coronary artery bypass grafting surgery were assigned to the development cohort (n=176) and the independent validation cohort (n=118). A total of 52 clinical variables were extracted for each patient. The principal clinical end point was the incidence of major adverse cardiovascular events, encompassing cardiac mortality, acute myocardial infarction, acute heart failure, and graft failure. From least absolute shrinkage and selection operator regression, 4 predictors were selected for the final prediction nomogram: diabetes, hypertension, the systemic immune‐inflammation index, and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide). The prediction nomogram achieved satisfactory prediction performance in both the development cohort (C index, 0.768 [95% CI, 0.701–0.835]) and independent validation cohort (C index, 0.633 [95% CI, 0.521–0.745]). Adequate calibration was noted for the likelihood of major adverse cardiovascular events in both the development and independent validation cohorts. Decision curve analysis confirmed the clinical usefulness of the established prediction nomogram.

Conclusions
A clinically feasible prognostic model, based on preoperative multimodal data, was developed for risk stratification of patients with ischemic heart and heart failure with preserved ejection fraction who receive coronary artery bypass grafting surgery.

Registration

https://www.chictr.org.cn
; Unique identifier: ChiCTR2300074439.
Coronary Microvascular Dysfunction Is Associated With Augmented Lysosomal Signaling in Hypercholesterolemic Mice
Authors: Wang Yun‐Ting , Moura Alexandra K. , Zuo Rui , Zhou Wei , Wang Zhengchao , Roudbari Kiana , Hu Jenny Z. , Li Pin‐Lan , Zhang Yang , Li Xiang 
Published: November 2024

Background
Accumulating evidence indicates that coronary microvascular dysfunction (CMD) caused by hypercholesterolemia can lead to myocardial ischemia, with or without obstructive atherosclerotic coronary artery disease. However, the molecular pathways associated with compromised coronary microvascular function before the development of myocardial ischemic injury remain poorly defined. In this study, we investigated the effects of hypercholesterolemia on the function and integrity of the coronary microcirculation in mice and the underlying mechanisms.

Methods and Results
Mice were fed a hypercholesterolemic Paigen's diet for 8 weeks. Echocardiography data showed that Paigen's diet caused CMD, characterized by significant reductions in coronary blood flow and coronary flow reserve, but did not affect cardiac remodeling or dysfunction. Immunofluorescence studies revealed that Paigen's diet–induced CMD was associated with activation of coronary arterioles inflammation and increased myocardial inflammatory cell infiltration. These pathological changes occurred in parallel with the upregulation of lysosomal signaling pathways in endothelial cells (ECs). Treating hypercholesterolemic mice with the cholesterol‐lowering drug ezetimibe significantly ameliorated Paigen's diet–induced adverse effects, including hypercholesterolemia, steatohepatitis, reduced coronary flow reserve, coronary endothelial cell inflammation, and myocardial inflammatory cell infiltration. In cultured mouse cardiac ECs, 7‐ketocholesterol increased mitochondrial reactive oxygen species and inflammatory responses. Meanwhile, 7‐ketocholesterol induced the activation of transcriptional factor EB and lysosomal signaling in mouse cardiac ECs, whereas the lysosome inhibitor bafilomycin A1 blocked 7‐ketocholesterol–induced transcriptional factor EB activation and exacerbated 7‐ketocholesterol–induced inflammation and cell death. Interestingly, ezetimibe synergistically enhanced 7‐ketocholesterol–induced transcriptional factor EB activation and attenuated 7‐ketocholesterol–induced mitochondrial reactive oxygen species and inflammatory responses in mouse cardiac ECs.

Conclusions
These results suggest that CMD can develop and precede detectable cardiac functional or structural changes in the setting of hypercholesterolemia and that upregulation of transcriptional factor EB–mediated lysosomal signaling in endothelial cells plays a protective role against CMD.
Is Bündnis Sahra Wagenknecht A New Alternative for Populist Voters?
Authors: Thomeczek Jan Philipp 
Published: November 2024

Abstract
In just five months, Bündnis Sarah Wagenknecht (BSW) progressed from its foundation to winning six seats in the European Parliament. Research has indicated that the party has significant potential, particularly among voters of Germany’s two populist parties: Alternative for Germany (AfD) and Die Linke. Since BSW is also classified as a populist party, this article explores the extent to which populist attitudes influence the vote choice preference for BSW. The analysis employs a three-dimensional populism scale, using data from a VAA-like website. The results reveal that voters intending to vote for BSW exhibit strong anti-elitist and people-centric views, but do not hold Manichean outlooks. This positions BSW voters ideologically between Die Linke and AfD voters in terms of populist ideation – albeit closer to the AfD, reflecting the party-level populism of BSW. Additionally, populist attitudes, particularly anti-elitism, are significant predictors of vote-switching from other parties to BSW.
Host resistance responses against Puccinia striiformis f. sp. tritici in wheat cultivars with different resistance levels: molecular, biochemical, and ultrastructural studies
Authors: El-Sharkawy Hany H. A. , Rashad Younes M. , Baka Zakaria A. M. , Madbouly Adel K. , Badeea Osama E. Abd El 
Published: November 2024

Abstract
Background
Yellow (stripe) rust of wheat, caused by Puccinia striiformis, is a serious disease that results in great economic losses. This study aimed to investigate the variation in plant responses in three wheat cultivars with different resistance levels against yellow rust.

Results
The highest disease severity was recorded for cv. Gemmieza-11 (95%), followed by cv. Shandweel 1 (60%), while the lowest was recorded for cv. Misr-3 (3%). qPCR results of the yellow rust-resistance genes Yr5, Yr10, Yr15, and Yr18 showed that the infection did not affect the expression of Yr5 and Yr15 in the infected Gemmieza-11 plants when compared to the non-infected control. In contrast, the infection significantly overexpressed Yr5 and Yr15 in cvs. Shandweel 1 and Misr-3. However, Misr-3 was superior in this regard, recording 3.85- and 4.07-fold for Yr5 and Yr15, respectively. In addition, the infection significantly upregulated Yr10 and Yr18 in the three tested cultivars, with the superiority for the cultivar Misr-3, followed by Shandweel 1. Activity of the antioxidant enzymes peroxidase, polyphenol oxidase, and catalase was significantly higher in the infected plants of cv. Misr-3 than in cv. Shandweel-1, while the lowest values were recorded in cv. Gemmieza-11. The increment in this activity was associated with a reduction in the lipid peroxidation in the three tested cultivars. The phenolic content considerably increased also upon infection in cv. Misr-3 followed by Shandweel-1 but not in cv. Gemmieza-11, compared to the non-infected plants. Transmission electron microscopy demonstrated that the infected mesophyll cells in cv. Gemmieza-11 showed abnormalities in the chloroplasts and thick-walled haustoria. On the contrary, the mesophyll cells in cv. Misr-3 showed no haustoria and well organized chloroplasts. The mesophyll cells in cv. Shandweel-1 displayed highly degenerated haustoria, a degenerated granulated cytoplasm, and a thick host cell wall, indicating intermediate defense responses against the invading pathogen. Plant growth, yield, and photosynthetic pigments were higher in cv. Misr-3, followed by cv. Shandweel-1, and the lowest values were recorded in cv. Gemmieza-11.

Conclusions
The obtained results displayed that Yr5 and Yr15 were more effective than Yr10 and Yr18, indicating their main roles in regulating multiple defense mechanisms and hypersensitive responses.
Stressors for farmworker parents during wildfire season
Authors: D’Evelyn Savannah M , Nerenberg Isabel , Blancas Maria , Rivera Laura , Suarez Alyssa , Drury Dennise O , Kasner Edward J 
Published: November 2024

Abstract
Background
The severity of wildfire seasons amplify stressors that farmworker families in the Pacific Northwest face as they balance childcare, work, and personal wellbeing. A lack of safe and attainable childcare has been a challenge for farmworker parents since before the Covid-19 pandemic and is of particular concern during wildfire season when parents must weigh the risks and benefits of leaving children at home, taking them to work, or sending them to childcare. This study describes how stressors of balancing childcare, work, and concerns about children’s exposure to smoke during wildfire season impact the wellbeing and workplace absenteeism and presenteeism for farmworker parents.

Methods
To understand the impact of this balancing act on farmworker parents, researchers from the University of Washington partnered with Wenatchee’s Community for the Advancement of Family Education to conduct interviews with 20 farmworker parents, and co-host two town hall discussion meetings within the community.

Results
Six qualitative themes emerged from our interviews including that farmworker parents feel both ill-prepared at home to protect their families, and also do not feel as though they are being provided with adequate resources at work to protect their own personal health. Through the town hall events, we learned that verbal messaging and storytelling are effective and appreciated routes of communication.

Conclusions
Overall, we found that messaging and effective communication around how to prepare for the worsening levels of smoke is lacking among the farmworker community. Future research will address the messaging and communication gaps that must be filled to protect the health of both workers and their families during smoke season and beyond.
The association of different types of stress, and stress accumulation with low back pain in call-center workers - a cross-sectional observational study
Authors: Brenner-Fliesser Michael , Houtenbos Sanne , Ewerton Marie , Bontrup Carolin , Visscher Rosa , Taylor William R. , Zemp Roland , Wippert Pia-Maria 
Published: November 2024

Abstract
Background
Low back pain (LBP) is a common health complaint and a prominent factor in the development of LBP among the working population is stress. Mostly, stress is addressed as a general problem, which is why LBP prevention programs are often imprecise. Accordingly, a closer look at the association between specific stress types and the development of LBP is necessary. Therefore, this paper aims (1) to identify the stress types most closely associated with LBP; (2) to examine the relationship between stress accumulation and LBP.

Methods
n = 100 call-center workers were approached for participation. Stress levels and LBP were assessed with questionnaires (TICS, ERI, CPG, BPI) and hair cortisol levels were measured (ELISA-KIT, 3-months period). Mann-Whitney U tests were used to identify stress types most closely associated with LBP. Further, ANCOVA analysis was conducted to determine the association of the number of experienced stress types with LBP intensity and impairment.

Results
Finally, data from n = 68 participants (mean age: 43.2 (± 12.8) years; 62% female) were used for presented analysis. Participants, who were affected by work-related stress showed higher pain severity (excessive demands at work: 23.6 ± 21.8 vs. 42.4 ± 25.0 (p = 0.005)) and more impairment (excessive demands at work: 13.7 ± 17.6 vs. 28.7 ± 22.3 (p = 0.003); work overload: 15.4 ± 20.4 vs. 26.3 ± 17.4 (p = 0.009)) than their less affected colleagues. Other stress types (e.g. Effort, Reward) showed no significant association with LBP. Furthermore, participants who experienced two or more of the most associated stress types simultaneously suffered from stronger pain and more impairment (p < 0.01).

Conclusions
The results suggest that it is essential to divide and evaluate stress in specific domains. Furthermore, the accumulation of different stress types and the resulting physiological load should be taken into account when designing prevention and intervention programs. Results may be of high relevance for the development of LBP prevention programs for people within a predominantly sitting working context.
How to establish and sustain a disease registry: insights from a qualitative study of six disease registries in the UK
Authors: Stubbs Edmund , Exley Josephine , Wittenberg Raphael , Mays Nicholas 
Published: November 2024

Abstract
Background
The advent of new chronic conditions such as long COVID-19 raises the question of whether and, if so, how best to establish new disease registries for such conditions. Prompted by the potential need for a long COVID-19 registry, we examined experiences of existing UK disease registries to understand barriers and enablers to establishing and sustaining a register, and how these have changed over time.

Methods
We undertook semi-structured interviews between November 2022 and April 2023 with individuals representing six disease registries that collect individual-level longitudinal data on people diagnosed with a chronic condition.

Results
Registries examined were developed by a few individuals, usually clinicians, to gain a greater understanding of the disease. Patient voices were largely absent from initial agenda setting processes, but, over time, all registries sought to increase patient involvement.
Securing long-term funding was cited as the biggest challenge; due to limited funds, one of the registries examined no longer actively recruits patients. Charities devoted to the diseases in question were key funders, though most registries also sought commercial opportunities. Inclusion on the NIHR Clinical Research Network Portfolio was also considered a vital resource to support recruitment and follow-up of participants.
All registries have sought to minimise the primary data collected to reduce the burden on clinicians and patients, increasingly relying on linkage to other data sources. Several registries have developed consent procedures that enable participants to be contacted for additional data collection. In some cases, the initial patient consent and data sharing permissions obtained had limited the flexibility to adapt the registry to changing data needs. Finally, there was a need to foster buy-in from the community of patients and clinicians who provide and/or use the data.

Conclusion
We identified six key considerations when establishing a sustainable disease registry: (1) include a diverse set of stakeholders; (2) involve patients at every stage; (3) collect a core data set for all participants; (4) ensure the data system is flexible and interoperable with the wider data landscape; (5) anticipate changing data needs over time; and (6) identify financial opportunities to sustain the registry’s activities for the long term.
Bridging cultural gaps in end-of-life care: the experiences of international charge nurses in Saudi Arabia
Authors: MANI Zakaria A. 
Published: November 2024

Abstract
Introduction
This qualitative study explores the experiences and perspectives of international intensive care unit charge nurses providing end-of-life care to Muslim patients in Saudi Arabia. It examines how these nurses navigate the complexities of delivering culturally sensitive care, particularly regarding Islamic beliefs and practices. The study also investigates the challenges encountered by international nurses due to differing healthcare expectations between themselves and patients’ families, highlighting the interplay between cultural sensitivity and effective end-of-life care in this unique context.

Method
A qualitative descriptive design was employed, using semi-structured interviews to gather data from eight international ICU charge nurses working in a tertiary hospital in Saudi Arabia. Thematic analysis was used to analyze the interview transcripts.

Results
This qualitative study explored the experiences of international ICU charge nurses in Saudi Arabia regarding culturally sensitive end-of-life care within Islamic traditions. Analysis revealed nine key themes and 31 subthemes reflecting the multifaceted nature of this sensitive domain. These themes encompassed intercultural anxieties, emotional burdens on families and nurses, the importance of bridging cultural divides, advocating for change in end-of-life care practices, and honoring diverse spiritual needs. Key findings emphasized the significance of family presence, honoring faith in the absence of family, and ensuring peaceful and compassionate passings, highlighting nurses’ commitment to holistic, patient-centered care that respects both cultural and individual beliefs..

Conclusion
This study provides valuable insights into the cultural nuances of end-of-life care in Saudi Arabia. The findings underscore the importance of culturally sensitive practices that respect Islamic beliefs, prioritize family involvement, and address the holistic needs of patients and their families.

Implications
This study underscores the need for culturally sensitive communication training for healthcare providers working with diverse patient populations. Hospitals and healthcare institutions should prioritize educational initiatives that equip staff with the skills to engage in open dialogues about death and dying, navigate cultural differences in end-of-life preferences, and address the use of traditional healing practices. By fostering greater cultural understanding and communication competency, healthcare systems can better support both patients and families in navigating the complexities of end-of-life care.
Patient pathways in primary health care – an interview study across various health care personnel in a Canadian and a Norwegian county
Authors: Nystrøm Vivian , Ohinmaa Arto , Leonardsen Ann-Chatrin Linqvist 
Published: November 2024

Abstract
Background
Due to demographic changes in the Western world governments emphasize the need for viable solutions, e.g. through decentralization of specialist health care services and better coordination within and between health care services. Both Norway and Canada have been through health care reforms and initiatives aiming to improve continuity and coordination of services. Organizational change to primary care in both countries encompasses both team-based service delivery involving allied health professionals, and new blended payment models. The objective of this study was to explore patient pathways in primary healthcare from various health personnel’s perspectives, and across various primary care organizations in Norway and Canada.

Methods
The study had a qualitative design, including interviews with physicians, nurses and managers (n = 19) in primary care, from a county in Norway and a region in Canada. Data were analyzed with a thematic approach, in line with recommendations from Braun & Clarke.

Results
Three themes were identified: 1) Structural challenges, 2) Towards a more specialized primary health care and 3) Dedication could improve continuity. Findings indicate that coordinating health care services was assumed difficult due to different health care levels, funding systems, managements, electronic record systems and organizations. Hospitals were assumed more task oriented, while primary health care services were considered more care oriented, and this challenged the coordination across organizations. Primary care services were perceived to be more and more specialized, also representing a threat for coordination and continuity. Health care personnel in both countries perceived that dedicated personnel for each patient could improve information flow and continuity across services.

Conclusions
Achieving continuity and coordination of health care services seems challenging. Integration strategies seem essential for reducing silo thinking and fragmentation of health care services.