bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advanced Clinical Practitioners’ Resilience and Emotional and Spiritual Well‐Being During COVID‐19
Authors: Rogers Melanie , Windle Angela , Wu Lihua , Taylor Vanessa , Bale Chris 
Published: December 2024

Aim: This study investigated the impact of the COVID‐19 pandemic on the emotional and spiritual well‐being and the resilience of advanced clinical practitioners in the United Kingdom.Background: Advanced clinical practitioners are experienced healthcare professionals educated to a master’s level who demonstrate expertise, professional judgment, and autonomy across four pillars of advanced practice. Normally, in nursing and the allied health professions, advanced clinical practitioners provide clinical leadership and improve clinical continuity by providing high‐quality care to patients through complex decision‐making and managing risk. The role contributes to workforce transformation enabling organizations to meet changing population, patient, and service delivery needs. Advanced clinical practitioners’ well‐being and resilience were particularly at risk during the pandemic due to the increased workload, moral distress, redeployment into other clinical areas, and isolation. Phase 1 of this study identified that advanced clinical practitioners had worryingly low levels of well‐being and resilience during the first 6 months of the pandemic. This paper reports Phase 2’ findings 1 year into the pandemic.Method: Three hundred and seventy‐one respondents completed an online survey comprising three validated scales assessing resilience and emotional and spiritual well‐being.Results: One year into the pandemic, advanced clinical practitioners reported a continued decline in their well‐being, with average scores on this measure being 12 percent lower compared to prepandemic levels Differences also emerged in the scores of advanced clinical practitioners practicing in primary and secondary care services.Conclusion: Our findings showed the ongoing deleterious impact of the pandemic on the well‐being and resilience of advanced clinical practitioners. As the attention of healthcare leaders shifts to the delivery of services post‐COVID‐19, the longer‐term impact of the pandemic on the mental health and well‐being of the workforce, alongside the ongoing workforce crisis in the UK and globally, means the well‐being and resilience of advanced clinical practitioners need urgent addressing if these role holders are to continue to lead patient care, workforce transformation, and service innovation. Tailored interventions to support advanced clinical practitioners appear necessary to prevent significant workforce impact including absenteeism, long‐term stress, sickness absence, and loss to the healthcare workforce.
Unveiling the Mechanism of Lurbinectedin’s Action and Its Potential in Combination Therapies in Small Cell Lung Cancer
Authors: Calles Antonio , Calvo Emiliano , Santamaría Nuñez Gema , Costanzo Federico , Guillén María José , Martinez Diez Marta , Gupta Aparna , Cuevas Carmen , Egly Jean-Marc , Avilés Pablo 
Published: December 2024

Abstract
Lurbinectedin is a selective inhibitor of oncogenic transcription approved for the treatment of adult patients with metastatic small cell lung cancer with disease progression on or after platinum-based chemotherapy. Preclinical data provide evidence for lurbinectedin exerting its actions in a unique manner that involves oncogenic transcription inhibition, DNA damage, reshaping of the tumor microenvironment, and inducing anticancer immunity. Understanding the mechanism of action has facilitated the rational combination of lurbinectedin and anticancer therapies with complementary modes of action, in order to obtain synergistic effects that could potentially lead to improved efficacy. This review evaluates the mechanism of action for lurbinectedin and provides an overview of the therapeutic landscape with regards to lurbinectedin combination therapies for the treatment of small cell lung cancer based on data from preclinical and clinical studies.
SGK1-Mediated Vascular Smooth Muscle Cell Phenotypic Transformation Promotes Thoracic Aortic Dissection Progression
Authors: Leng Shuai , Li Haijie , Zhang Pengfei , Dang Zhiqiao , Shao Baowei , Xue Shishan , Ning Yansong , Teng Xilong , Zhang Leilei , Wang Honglu , Li Na , Zhang Fengquan , Yu Wenqian 
Published: December 2024

BACKGROUND:
The occurrence of thoracic aortic dissection (TAD) is closely related to the transformation of vascular smooth muscle cells (VSMCs) from a contractile to a synthetic phenotype. The role of SGK1 (serum- and glucocorticoid-regulated kinase 1) in VSMC phenotypic transformation and TAD occurrence is unclear.

METHODS:

Four-week-old male Sgk1
F/F
(
Sgk1
floxed) and Sgk1
F/F
;Tagln
Cre
(smooth muscle cell–specific
Sgk1
knockout) mice were administered β-aminopropionitrile monofumarate for 4 weeks to model TAD. The SGK1 inhibitor GSK650394 was administered daily via intraperitoneal injection to treat the mouse model of TAD. Immunopurification and mass spectrometry were used to identify proteins that interact with SGK1. Immunoprecipitation, immunofluorescence colocalization, and GST (glutathione S-transferase) pull-down were used to detect molecular interactions between SGK1 and SIRT6 (sirtuin 6). RNA-sequencing analysis was performed to evaluate changes in the SIRT6 transcriptome. Quantitative chromatin immunoprecipitation was used to determine the target genes regulated by SIRT6. Functional experiments were also conducted to investigate the role of SGK1-SIRT6-MMP9 (matrix metalloproteinase 9) in VSMC phenotypic transformation. The effect of SGK1 regulation on target genes was evaluated in human and mouse TAD samples.

RESULTS:

Sgk1
F/F
;Tagln
Cre
or pharmacological blockade of Sgk1 inhibited the formation and rupture of β-aminopropionitrile monofumarate–induced TADs in mice and reduced the degradation of the ECM (extracellular matrix) in vessels. Mechanistically, SGK1 promoted the ubiquitination and degradation of SIRT6 by phosphorylating SIRT6 at Ser338, thereby reducing the expression of the SIRT6 protein. Furthermore, SIRT6 transcriptionally inhibits the expression of MMP9 through epigenetic modification, forming the SGK1-SIRT6-MMP9 regulatory axis, which participates in the ECM signaling pathway. Additionally, our data showed that the lack of SGK1-mediated inhibition of ECM degradation and VSMC phenotypic transformation is partially dependent on the regulatory effect of SIRT6-MMP9.

CONCLUSIONS:
These findings highlight the key role of SGK1 in the pathogenesis of TAD. A lack of SGK1 inhibits VSMC phenotypic transformation by regulating the SIRT6-MMP9 axis, providing insights into potential epigenetic strategies for TAD treatment.
Cost-Effectiveness of Intensive Blood Pressure Control in Youth With Chronic Kidney Disease
Authors: Vincent Carol L. , Poehling Katherine A. , Rigdon Joseph , Schaich Christopher L. , South Andrew M. , Downs Stephen M. 
Published: December 2024

BACKGROUND:
Intensive blood pressure (BP) control in youth with chronic kidney disease (CKD) slows progression, delaying the need for kidney replacement therapy (KRT). Most youth with CKD have hypertension and BP control is difficult to achieve outside of controlled experimental settings. Implementing effective BP control strategies in this population may be cost-saving despite requiring additional resources. Our objective was to determine the economic and clinical impact of intensive versus usual care for BP management in youth with CKD in a microeconomic model.

METHODS:
We developed a decision tree from the US payer perspective to estimate the total costs and clinical effect of an intensified BP intervention over 5 years, modeled after the ESCAPE trial (Effect of Strict Blood Pressure Control and Angiotensin-Converting Enzyme [ACE] Inhibition on Progression of Chronic Renal Failure in Pediatric Patients) protocol. We compared this intervention to usual care in a hypothetical population of youth with mild-to-moderate CKD. Probabilities were informed by published literature; cost estimates were informed by publicly available data. Our outcomes were the net discounted cost of an intensive BP intervention, number needed to treat with the intervention to prevent 1 KRT episode, and incremental cost per KRT episode avoided.

RESULTS:
An intensive BP intervention, with a goal of an average 24-hour mean arterial pressure <50th percentile, improved outcomes with net cost savings of $9440 per participant over 5 years compared with usual care. To prevent 1 episode of KRT over 5 years, 13 participants need to receive intensive BP intervention.

CONCLUSIONS:
Routine use of the ESCAPE protocol for intensive BP control in youth with CKD could save overall costs for the payer and improve clinical outcomes.
Biafran Separatism in Post-War Nigeria: Religious Identity, Intergroup Threats, and the (In)compatibility of Christianity and Islam
Authors: Ossai Emmanuel Chiwetalu , Okwueze Malachy Ikechukwu 
Published: December 2024

Abstract
The Republic of Biafra was created out of Nigeria on May 30, 1967. Consisting mainly of Igbo Christians, Biafra officially ceased to exist on January 15, 1970, following a 30-month war. Most studies of the contemporary demand among some Igbo people for Biafra’s restoration do not examine its religious dimension, and the minimal research on its religious drivers has paid less attention to the Igbo Christian identity, despite the significant position of Christianity in Igboland and Eastern Nigeria more broadly. Data obtained from July to October 2020 through 21 key informant interviews and 229 questionnaire respondents from Nigeria indicates that the present-day support for Biafra’s restoration is partially motivated by Christian identity, perceived realistic and symbolic threats from Islam and northern Nigerian Muslims, and a notion that Christianity and Islam are incompatible. To address separatism in Nigeria, a strategic response should take its religious drivers into account.
Challenging the Narrative
Authors: Gupta Vishwas , Yadav Prashant Dev 
Published: December 2024

Abstract
This article delves into the complex issues surrounding majoritarian fundamentalism and minority insecurity in contemporary India. It carefully examines the various ways in which majoritarian influence manifests in Indian society, including electoral trends, legislative decisions, and public discourse data. Rather than presenting a simplistic view of majoritarianism as a uniform and unchanging force, the article argues that it is a contested terrain shaped by historical, socio-political, and economic factors. The analysis highlights instances where majoritarian policies have been challenged and minority rights upheld, demonstrating the resilience of democratic principles and social movements. The article also critiques sensationalist media portrayals that perpetuate stereotypes and divisive narratives, advocating for responsible journalism that fosters understanding and empathy across communities. Ultimately, the article emphasizes the importance of inclusive leadership, dialogue, and collaboration in building cohesive societies, drawing on successful inter-community harmony and grassroots cooperation models. It underscores the need for nuanced discourse and evidence-based analysis to address systemic injustices and promote social cohesion in India.
Sinful Worlds, Divine Purposes, and Justifications of Slavery in Alonso de Sandoval’s De instauranda Aethiopum salute
Authors: Clay George 
Published: December 2024

Abstract
To twenty-first-century eyes, the question of how Jesuits could minister to enslaved people, while simultaneously enslaving them, can seem hard to resolve. This article examines the work of the Jesuit Alonso de Sandoval (1576–1652), De instauranda Aethiopum salute, as a window into the worldview of a Jesuit who was also an enslaver. The apparent tension between the two Jesuit activities of ministry and slaveholding has often led to distorted representations of Sandoval as a humanitarian or proto-abolitionist. This article seeks to resolve the apparent tension by examining Sandoval as a religious thinker who articulated justifications of transatlantic slavery. It argues that in De instauranda a view of the temporal world as inherently sinful, and a faith in God’s ultimate plan for the salvation of the fallen world, combined to justify and celebrate transatlantic slavery as an instrument of salvation. Sandoval’s faith in divinely ordained hierarchies meant that he saw no contradiction between Christian charity and colonial slavery. This worldview deserves further attention from scholars who wish to understand the mentalité of the seventeenth-century Society of Jesus on its own terms.
Sola voce triumphat: Festivities for the Beatification of Ignatius of Loyola in Goa in 1610
Authors: Teles e Cunha João , Pereira Coutinho Maria João 
Published: December 2024

Abstract
A rare manuscript kept in Torre do Tombo (Lisbon, Portugal) preserves the memory of several celebrations of the beatification of Ignatius of Loyola, which took place around the realms of the Spanish Habsburgs in 1609–11. Among these, there is the account of those organized in Goa in 1610, whose narrative reveals the cultural hybridization of European and Indian influences, in a nod to the local population to make readable the Jesuit message to a wider audience. Such Indian influences also reflected the origin of the craftsmen employed in constructing vehicles, decorations, and machines, whose cultural background conditioned the final result. The Jesuit narrative, however, depicted Indians either as props (used in procession for their exoticism) or as bystanders (as no one is individualized in the narrative, except key official figures invited by the Society to participate in the celebration).
An Imagological Analysis of the Video Game Black Myth: WuKong
Authors: Yuan Wenjie 
Published: December 2024

Abstract
In this paper, an analytical approach is applied to the globally acclaimed game, Black Myth: Wukong, inspired by the classic novel Journey to the West, which stands out in the transmission of Chinese culture. A model is proposed, taking into account four basic concepts: proto-image, image ontology, image realization, and image reception, tracing the literary sources manifested in the game. The exploration covers how narrative structures, multimodal systems, and gameplay change during the transition from text to game. Finally, the reception and evaluation of these changes are examined, illustrating the interactive process between game developers as image creators and players as image receivers. The formation of images in the digital era is viewed as distinct from traditional media and urgently needs attention.
The predictive value of miR-29b-2-5p on the prognosis of cervical cancer and its inhibitory effect on cervical cancer progression
Authors: Liu Qinghan , Chen Xi , Zhang Wenhui , Shang Wei , Cao Jinwei , Zhao Huijuan , Jian Feng 
Published: December 2024

Objective The poor prognosis of cervical cancer patients leads to an annual increase in mortality, while microRNAs are involved in various cancers, including cervical cancer. This study aimed to investigate the clinical value and possible effect of miR-29b-2-5p on the progression of cervical cancer. Methods The expression level of miR-29b-2-5p in cervical cancer tissues and cells was analyzed by polymerase chain reaction. The Kaplan–Meier curve was used to evaluate the role of miR-29b-2-5p in cervical cancer prognosis. The independent prognostic factors of cervical cancer were explored by the multivariate Cox regression analysis. The effect of miR-29b-2-5p on the proliferation, migration, and invasion of cervical cancer cells was determined by in vitro cell experiments. Results A significantly downregulated miR-29b-2-5p expression was observed in cervical cancer tumor tissues and cervical cancer cells compared with the adjacent tumor tissues (tissues of the negative surgical margin) and H8 cells, respectively. Higher miR-29b-2-5p expression correlated with a better 5-year progression-free survival of cervical cancer. MiR-29b-2-5p was also associated with the indicators (tumor size, tumor differentiation, FIGO (International Federation of Gynecology and Obstetrics) stage, and invasion depth) of the progression of cervical cancer tumors. And miR-29b-2-5p, along with tumor size, tumor differentiation, FIGO stage, histology type, and invasion depth, were independent prognostic factors for poor cervical cancer prognosis. MiR-29b-2-5p showed a suppressive effect on the proliferation, migration, and invasion of cervical cancer cells. Conclusions MiR-29b-2-5p was downregulated in cervical cancer tumor tissues and could serve as an independent prognostic factor for cervical cancer. The overexpressed miR-29b-2-5p could be considered a tumor suppressor to inhibit the progression of cervical cancer.
Impact of Stress on the Endocannabinoid System: A [11C]-CURB Positron Emission Tomography Study in Early Psychosis: Les effets du stress sur le système endocannabinoïde : étude par tomographie par émission de positons avec l’indicateur radioactif [11C-CURB] dans la psychose précoce
Authors: Weidenauer Ana , Garani Ranjini , Campos Oller Paula , Belén Blasco Maira , Rusjan Pablo M. , Mizrahi Romina 
Published: December 2024

Background Stress and traumatic experiences are well-established risk factors for psychiatric disorders. Stressful events can induce symptoms of anxiety and depression and may lead to overt psychosis, especially when there is an innate biological vulnerability. This study explores the role of the stress-regulating endocannabinoid system, specifically the activity of the enzyme fatty acid amid hydrolase (FAAH), a key regulatory enzyme for endocannabinoids, in association with stress by analysing data from healthy individuals and patients with psychosis. Methods We performed a post-hoc exploratory analysis on 65 positron emission tomography scans using the selective FAAH radioligand [11C]CURB, encompassing 30 patients with psychosis (6 female) and 35 healthy controls (19 female). The study aimed to examine the association between FAAH activity and stressful life events, assessed through the Recent Life Events, Survey of Life Experiences, and Hassles and Uplifts Scale. Results There was a significant difference regarding the number of recent stressors with higher levels in patients compared to healthy subjects (Survey of Life Experiences: t = 4.88, p < 0.001, hassles: t = 3.14, p = 0.003), however there was no significant relationship of brain FAAH activity and stressful life events in any of the applied scales across groups (Recent Life Events: F1,57 = 0.07, p = 0.80; Survey of Life Experiences: F1,57 = 1.75, p = 0.19; hassles: F1,56 = 1.06, p = 0.31). Linear mixed models performed separately for each group revealed that there was a positive association between FAAH activity and Recent Life Events in patients with psychosis only ( F1,25 = 8.07, p = 0.009). Conclusions Our data reveal a significant disparity in recent stressors between the two groups, and a correlation between brain FAAH activity and stressful life events in patients with psychosis only. This suggests a complex interplay between stress and the endocannabinoid system.
Factors Influencing Knowledge, Attitudes and Behaviour Towards Engaging with Advance Care Planning: A Cross-Sectional Survey of Chinese Diaspora
Authors: Li Zhuangshuang , McIlfatrick Sonja , Hasson Felicity , Beck Esther-Ruth 
Published: December 2024

Objective Advance care planning (ACP) is increasingly recognized as a public health priority globally, with cultural aspects influencing people's knowledge, attitudes, and behaviours toward ACP. Despite being one of the largest diaspora groups, the Chinese community remains under-researched in this area. This study aims to examine the knowledge, attitudes, and health behaviours related to ACP among Chinese diaspora within a region in the United Kingdom. Method A cross-sectional online survey based on the Theory of Planned Behaviour was conducted with 284 Chinese adults recruited from four social and voluntary organisations in the United Kingdom. Results The study found low awareness (15%) and knowledge (mean score: 2.26 ± 1.78) of ACP, with less than 5% of the participants engaging with ACP. This contrasted with participants’ attitudes (17.24 ± 2.57) and behavioural intention (14.93 ± 3.26) toward ACP, which were generally positive. Behavioural intention was the strongest predictor of engaging with ACP (OR 3.29, 95% CI: 1.35-8.02, p = 0.01). Participants with previous end-of-life care experience had a better understanding of ACP; older age and higher knowledge of ACP were associated with more positive attitudes. Cultural beliefs associated with the level of family involvement, legal aspects, and the availability of information in one's first language was significant influences on engagement with ACP. Conclusions Despite low awareness and engagement with ACP among the Chinese diaspora, positive attitudes and behavioural intention suggest potential for increased engagement. This could be achieved through culturally tailored interventions that address cultural influences and complexity surrounding legal requirements. Further research is needed to develop and test such interventions.
Ultrarare Cause of Childhood Chorea: Celiac Disease
Authors: Ozbudak Pinar 
Published: December 2024

Introduction Chorea, a movement disorder that commonly affects children, may be caused by various diseases with metabolic, structural, pharmacologic, or autoimmune origins. Celiac disease is an autoimmune enteropathy that may rarely cause neurologic symptoms in children, primarily ataxia and peripheral neuropathy, even in the absence of gastrointestinal symptoms. Case Report A 9-year-old male patient diagnosed with Sydenham chorea was admitted to our clinic because of valproic acid resistance. He had involuntary, brief, random, and irregular movements in his arms over the past 2 weeks. A low-dose, high-potency dopamine-2 receptor–blocking agent was added to the patient's treatment regimen. After 2 weeks, he had maculopapular rashes on their hands and arms, as well as arthritis in his left hand. Oral prednisone was prescribed, and the patient's arthritis and rashes were completely resolved. Although movement disorder symptoms persisted in the distal left upper extremity, the chorea in the right upper extremity was recovered. Extensive investigations were conducted to rule out possible metabolic, autoimmune, inflammatory, infectious, and paraneoplastic diseases, all of which yielded normal results. Brain magnetic resonance imaging (MRI) results were normal, and genetic analysis results for chorea were negative. The patient's tissue glutaminase IgG levels exceeded 200 U/mL (normal range: 0-10 U/mL) and IgA levels at 24 U/mL (normal range: 0--10 U/mL), leading to a diagnosis of celiac disease. His duodenal biopsies showed changes consistent with gluten-sensitive enteropathy. After the diagnosis of celiac disease, the patient began a gluten-free diet and remained free of chorea at the 6-month follow-up. Discussion Chorea is a rare neurologic celiac disease manifestation that can be reversible. The celiac disease should be considered in the diagnostic workup of chorea for all ages, particularly in the treatment-resistant population, even in the absence of gastrointestinal symptoms. This report presents the first known case of chorea caused by celiac disease in a pediatric patient.