bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supplementation with probiotics, prebiotics, and synbiotics in patients with chronic functional constipation: a randomized, double-blind, placebo-controlled pilot clinical trial
Authors: Terrén Lora Ana , Penadés Bruno F , López Oliva Sara , Arponen Sari , Okutan Gülşah , Sánchez Niño Guerthy Melissa , San Mauro Martín Ismael 
Published: October 2024

Abstract

Background
Functional constipation includes a set of gastrointestinal symptoms unexplainable by an identifiable underlying physical cause or pathology. The prevalence of this condition is high and there is a need to develop strategies to reduce it. Probiotics, prebiotics, and synbiotics may be an alternative treatment for chronic functional constipation.

Methods
To compare the efficacy of dietary supplementation on symptoms of patients who suffer from chronic functional constipation. An exploratory, randomized, double-blind, placebo-controlled pilot clinical trial was conducted with 74 patients diagnosed with chronic functional constipation who were divided into four treatment groups—Group A: probiotics; Group B: prebiotics; Group C: synbiotics; Group D: placebo. Each patient was treated for 8 weeks. At the beginning and end of treatment, data were collected by administering questionnaires and scales, including the Bristol stool scale, on gastrointestinal symptoms, bowel movements, and sociodemographic and anthropometric characteristics.

Results
Stool frequency increased in all four study groups, and greatest difference was observed in the synbiotics group (2.8 ± 1.3 vs. 5.9 ± 2.6; P &lt; 0.001). Stool consistency improved only in the active treatment groups. Based on the evaluation of gastrointestinal symptoms, participants treated with prebiotics, probiotics and synbiotics showed the greatest improvement in abdominal pain (8.28 ± 2.63 vs. 6.56 ± 2.62; P = 0.009), gastroesophageal reflux (4.60 ± 2.66 vs. 3.45 ± 2.42; P = 0.039) and constipation symptoms (13.00 ± 3.97 vs. 8.71 ± 3.35; P = 0.003), respectively. As for quality of life, the main changes were observed in physical health domains, with a placebo effect.

Conclusions
The present study provides evidence supporting the efficacy of dietary supplementation with probiotics, prebiotics, and synbiotics in patients with chronic functional constipation after 8 weeks of treatment.
Safety culture in focus: review of patient safety culture survey results in Primary Health Care Corporation Qatar
Authors: AlAbdulmalik Reem , Khattabi Nawal , Francis Reena , Manoharan Divya , Al-Ali Amal , Abdulmalik Mariam 
Published: October 2024

Abstract

Background
Patient safety is a crucial aspect of every health care organization and understanding the safety culture is essential for improving patient health outcomes. Evaluating the patient safety culture enables the health care organizations to gain insights into how their internal system’s structure and processes impact the patient’s overall well-being. In this paper, the Hospital Survey On Patient Safety (HSOPS) that is adopted from Agency for Healthcare Research and Quality (AHRQ) was used to examine the patient safety culture in the Primary Health Care Corporation in Qatar (PHCC), allowing for a better understanding of areas of strength and areas that require improvements.

Objectives
The aim of this study is to identify factors that contribute to a positive patient safety culture within PHCC Qatar utilizing the AHRQ HSOPS. Additionally, the study explores the barriers to enhancing the culture through qualitative data and evaluate its impact on health outcomes and care quality.

Method
The study aimed at comparing the organization’s safety culture in 2021 and its improvement in 2023. The survey was disseminated into 28 primary health centers with different sizes and patient volumes. The survey was sent electronically to all PHCC staff, allowing for better convenience and higher response rate.

Results
The results of this survey revealed numerous areas of strength, including teamwork across departments, error reporting, management support, communication error, non-punitive response to errors and staffing. On the other side, survey composites such as continuous learning and teamwork within department were identified as areas for improvement.

Conclusion
By allowing for better insights into the culture of safety and identifying areas of strength and weaknesses, PHCC can make informed decisions and implement effective interventions. This will support in enhancing the health and wellbeing of Qatar’s population that aligns with the national health strategies, which improves the overall health care in the region.
Rickettsia rickettsii subsp californica subsp nov, the Etiologic Agent of Pacific Coast Tick Fever
Authors: Paddock Christopher D , Karpathy Sandor E , Henry Asa , Ryle Luke , Hecht Joy A , Hacker Jill K , Padgett Kerry A , Kjemtrup Anne M , Bullock Hannah , Lane Robert S , Ladner Jason T 
Published: October 2024

Abstract
The etiologic agent of Pacific Coast tick fever, a moderately severe tickborne illness that resembles Rocky Mountain spotted fever (RMSF), was first isolated in 1966 from specimens of Dermacentor occidentalis (the Pacific Coast tick) obtained in California. For several decades, this bacterium was identified ambiguously as the unclassified spotted fever group Rickettsia species 364-D, Rickettsia 364, or Rickettsia philipii. However, none of these epithets satisfied criteria of formal bacterial nomenclature. Data developed from mouse serotyping studies performed &gt;45 years ago, and multilocus sequence typing several decades later, indicated that this bacterium was similar to, but distinct from, isolates of Rickettsia rickettsii, the etiological agent of RMSF. We applied an integrative taxonomic approach, combining phenotypic, ecological, and clinical data with whole-genome sequencing of 11 contemporary isolates of this pathogen to identify it as a distinct subspecies of R. rickettsii, and propose the name Rickettsia rickettsii subsp californica subsp nov.
Associations between tripartite dimensions of internalizing symptoms and transition readiness in a sample of emerging adults with and without chronic physical health conditions
Authors: Macaulay Taylor , Buscemi Joanna , Tran Susan , Miller Steven A , Greenley Rachel Neff 
Published: October 2024

Abstract

Objective
Theoretical models note psychosocial functioning as a key influence on transition readiness skills (TRS) among emerging adults (EA), but little is known about the relative importance of unique vs. shared anxiety and depressive dimensions, operationalized according to Clark and Watson’s (1991) tripartite model, in contributing to TRS. Moreover, although development of TRS is important for all EA, few studies have examined whether the strength of relationships between internalizing symptoms and TRS vary between EA with and without chronic physical health conditions (CHC). Given the links between suboptimal TRS and adverse health outcomes, additional research is needed. This study examined individual and additive associations between three internalizing symptom dimensions (anxious arousal, anhedonic depression, and general distress) and TRS, as well as the moderating role of CHC status.

Method
One hundred twenty-six EA completed an online survey measuring TRS and internalizing symptoms. The sample was 70.6% women, 39.7% of minoritized racial identity, and 21.2% Hispanic ethnicity. The mean participant age was 21.23 years.

Results
In two of three regression models, anhedonic depression alone was significantly related to TRS. CHC moderated the relationship between internalizing and TRS in only two of nine models. In both cases, internalizing symptoms were negatively associated with TRS for those without CHCs, but not for those with CHCs.

Conclusions
Assessment of anhedonic depression may be particularly useful in identifying youth at risk for suboptimal TRS regardless of CHC status. Moreover, interventions such as behavioral activation to improve TRS skill attainment warrant additional investigation.
FINE CULM1 Encoding a TEOSINTE BRANCHED1-like TCP Transcription Factor Negatively Regulates Axillary Meristem Formation in Rice
Authors: Tanaka Wakana , Ohyama Ami , Toriba Taiyo , Tominaga Rumi , Hirano Hiro-Yuki 
Published: October 2024

Abstract
Shoot branching is a critical determinant of plant architecture and a key factor affecting crop yield. The shoot branching involves two main processes: axillary meristem formation and subsequent bud outgrowth. While considerable progress has been made in elucidating the genetic mechanisms underlying the latter process, our understanding of the former process remains limited. Rice FINE CULM1 (FC1), which is an ortholog of teosinte branched1 in maize (Zea mays) and BRANCHED1/2 in Arabidopsis (Arabidopsis thaliana), is known to act in the latter process by repressing bud outgrowth. In this study, we found that FC1 also plays a role in the former process, i.e. axillary meristem formation, in rice. This study was triggered by our unexpected observation that fc1 mutation suppresses the loss of axillary meristems in the loss-of-function mutant of the rice WUSCHEL gene TILLERS ABSENT1 (TAB1). In tab1 fc1, unlike in tab1, both stem cells and undifferentiated cells were maintained during axillary meristem formation, similar to the wild type. Morphological analysis showed that axillary meristem formation was accelerated in fc1, compared to the wild type. Consistent with this, cell proliferation was more active in the region containing stem cells and undifferentiated cells during axillary meristem formation in fc1 than in the wild type. Taken altogether, these findings suggest that FC1 negatively regulates axillary meristem formation by mildly repressing cell proliferation during this process.
RNA sequencing uncovers key players of cartilage calcification: potential implications for osteoarthritis pathogenesis
Authors: Bernabei Ilaria , Faure Elodie , Wegrzyn Julien , Bertheaume Nicolas , Falgayrac Guillaume , Hugle Thomas , Nasi Sonia , Busso Nathalie 
Published: October 2024

Abstract

Objective
OA is a joint disease linked with pathologic cartilage calcification, caused by the deposition of calcium-containing crystals by chondrocytes. Despite its clinical significance, the precise mechanisms driving calcification remain elusive. This study aimed to identify crucial players in cartilage calcification, offering insights for future targeted interventions against OA.

Methods
Primary murine chondrocytes were stimulated with secondary calciprotein particles (CPP2) or left untreated (NT) for 6 h. Calcification was assessed by alizarin red staining. RNA was analysed by Bulk RNA sequencing. Differentially expressed (DE) genes were identified [cutoff: abs(LogFC)&gt;1 and adjusted P-value &lt; 0.05], and top 50 DE genes were cross-referenced with human OA datasets from previous studies (i.e. healthy vs. OA cartilage, or undamaged vs. damaged cartilage). RNA from NT and CPP2-stimulated primary human OA chondrocytes were used to validate genes by qPCR.

Results
CPP2 induced crystal formation by chondrocytes and significantly modulated 1466 genes. Out of the top 50 DE genes in CPP2, 27 were confirmed in published OA cartilage datasets. Of those genes, some are described in calcification and/or OA (Errfi1, Ngf, Inhba, Col9a1). Two additional ones (Rcan1, Tnfrsf12a) appear novel and interesting in the context of calcification and OA. We validated modulation of these six genes in calcifying human chondrocytes from five patients. Ultimately, we unveiled two distinct gene families modulated by CPP2: the first comprised cytoskeletal genes (Actb, Tpm1, Cfl1, Tagln2, Lmna), while the second encompassed extracellular matrix genes (Fmod, Sparc, Col9a1, Cnmd).

Conclusion
CPP2 modulates genes in chondrocytes that could represent new targets for therapeutic interventions in OA.
Neurosurgical Procedures in Patients Requiring Extracorporeal Membrane Oxygenation
Authors: Lee Ryan , Helmy Samantha , Cardona Jeronimo , Zhao David , Rector Raymond , Rabin Joseph , Mazzeffi Michael , Cho Sung-Min , Parikh Gunjan , Morris Nicholas A. , Khan Imad 
Published: October 2024

OBJECTIVES:
Extracorporeal membrane oxygenation (ECMO) is often withheld in patients with significant neurologic injury or recent neurosurgical intervention due to perceived futility. Studies of neurosurgical interventions before or during ECMO are limited to case reports or single-center series, limiting generalizability, and outcomes in this population are unknown. We therefore sought to report the outcomes of ECMO patients with acute neurosurgical interventions at four high-volume ECMO and comprehensive stroke centers.

DESIGN:
Retrospective case series.

SETTING:
Four academic tertiary referral hospitals in the United States.

PATIENTS:
Adults (n = 24) having undergone neurosurgical procedures before or during ECMO.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We retrospectively reviewed adults at four institutions who had undergone neurosurgical procedures immediately before or during ECMO from 2015 to 2023. The primary outcome was survival to hospital discharge. Secondary outcomes included favorable neurologic outcome (Cerebral Performance Category 1 or 2) and neurosurgical complications. Twenty-four of 2957 ECMO patients (0.8%) were included. Primary indications for neurosurgical intervention included traumatic brain (n = 8) or spinal (n = 3) injury, spontaneous intracranial hemorrhage (n = 6), and acute ischemic stroke (n = 5). Procedures included extraventricular drain (EVD) and/or intracranial pressure monitor placement (n = 10), craniectomy/craniotomy (n = 5), endovascular thrombectomy (n = 4), and spinal surgery (n = 3). Fifteen patients (63%) survived to hospital discharge, of whom 12 (80%) were discharged with favorable neurologic outcomes. Survival to discharge was similar for venoarterial and venovenous ECMO patients (8/12 vs. 7/12; p = 0.67) and those who had neurosurgery before vs. during ECMO (8/13 vs. 7/11; p = 0.92). One patient (4%) experienced a neurosurgical complication, a nonlethal tract hemorrhage from EVD placement. Survival to discharge was similar for neurosurgical and nonneurosurgical ECMO patients at participating institutions (63% vs. 57%; p = 0.58).

CONCLUSIONS:
Patients with acute neurologic injury can feasibly undergo neurosurgery during ECMO or can undergo ECMO after recent neurosurgery. Larger studies are needed to fully understand risks for bleeding and other procedure-related complications.
Associations Between Clinical Factors and Postoperative Thrombosis in Pediatric Cardiac Surgery Patients: A Single-Center Retrospective Study
Authors: Chlench Sven , Freudenthal Noa J. 
Published: October 2024

IMPORTANCE:
Postoperative thrombosis is a significant complication in pediatric cardiac surgery patients, contributing to morbidity and mortality. Identifying clinical factors associated with thrombosis can improve patient outcomes by guiding early detection and intervention.

OBJECTIVES:
This study aimed to assess factors associated with postoperative thrombosis or thromboembolism in pediatric patients under 12 months old who underwent surgery for congenital heart disease (CHD). Design, Setting, and Participants: This retrospective cohort study analyzed electronic medical records from pediatric patients admitted to the Pediatric Cardiovascular Intensive Care Unit (PCICU) at the German Paediatric Heart Center, Bonn, between March 1, 2020, and March 1, 2021. A total of 197 children under 12 months old who underwent cardiac surgery were included in the analysis.

MAIN OUTCOMES AND MEASURES:
Thrombosis was diagnosed postoperatively using imaging modalities such as ultrasound, echocardiography, and computed tomography. The primary outcome was the incidence of thrombosis and its association with clinical factors such as age, central venous catheter (CVC) duration, CRP levels, and D-dimer levels.

RESULTS:
Among 197 patients, the incidence of thrombosis was 8.63%, predominantly venous (70.6%). Initial associations were observed between thrombosis and younger age, lower body weight, higher hematocrit, cyanosis, longer central venous catheter (CVC) use, and elevated C-reactive protein (CRP) and d-dimer levels. Receiver operating characteristic analysis indicated a higher risk in patients with d-dimer levels above 5.47 mg/L. The stepwise multiregression analysis identified longer CVC duration in situ (β = 0.553; p < 0.001), higher CRP levels (β = 0.217; p = 0.022), and younger age at admission (β = –0.254; p = 0.006) as significant predictors of thrombosis. Decision tree analysis identified CVC use longer than 12.5 days and CRP levels above 118.01 mg/L as the most critical risk factors.

CONCLUSIONS AND RELEVANCE:
Postoperative thrombosis is a notable risk in pediatric CHD patients, particularly in neonates. Prolonged CVC use and elevated CRP levels are critical risk factors. Routine monitoring of D-dimer and CRP levels, along with timely sonographic screening, can aid early thrombosis detection and intervention. Further research is warranted to optimize thrombosis prevention strategies in this population.
Living From Test to Test: A Concept Analysis of CA-125 Preoccupation in Ovarian Cancer Survivorship
Authors: Gormley Maurade , Dunnack Yackel Hayley , Redeker Nancy S. 
Published: October 2024

Background:
Ovarian cancer has a high risk of recurrence and is rarely curable. One method for monitoring recurrence is trending Cancer antigen 125 (CA-125) levels. However, treatment based on rising CA-125 levels is controversial, often contributing to anxiety and an excessive focus on test results, described as “CA-125 preoccupation.”

Objective:
To present an analysis on the concept of CA-125 preoccupation.

Methods:
Rodgers’ method of evolutionary concept analysis was used to evaluate the attributes, antecedents, and consequences. PubMed, Medline, PsycINFO, and CINAHL electronic databases were searched.

Results:
Antecedents include a diagnosis of ovarian cancer that necessitates CA-125 surveillance, awareness of CA-125 as a tumor marker, and perceived disease status. Attributes include psychosocial symptoms characterized by a fixation with CA-125 levels and symptoms of anxiety, depression, distress, and illness intrusiveness that present in a cyclical pattern. Consequences include urgency to treat rising levels and surveillance and survivorship care preferences.

Conclusions:
CA-125 preoccupation is characterized by psychosocial symptoms that present in a cyclical and dynamic state akin to living “test to test” or feeling suspended in a perpetual cycle of tests, driven by a desire to feel relief or prompt action.

Implications for Practice:
Nurses are poised to influence the patient’s experience through identification of the presence of CA-125 preoccupation and its consequences. Understanding the antecedents and attributes of CA-125 may assist with identifying women who are most at risk.

What is Foundational:
This research presents the first known conceptual definition of CA-125 preoccupation, which may lead to validated survey measures and improved survivorship care.
Understanding what it is like to experience pain as you grow up: a poetic meta-ethnography
Authors: Toye Francine , Hannink Erin , Woolverton Amy , Barker Karen L. 
Published: October 2024

Abstract
A recent Lancet Commission raised concerns about the management of child and adolescent pain. We aimed to undertake a comprehensive review of qualitative research to understand children and adolescent pain experiences across contexts. We used the 7 stages of meta-ethnography to synthesise findings. We combined the strengths of arts-based methods, translating themes into poems in a range of languages. We screened 7471 titles, 464 abstracts, and 302 full texts, including 189 reports (177 unique samples) incorporating 5875 young people. Age range across studies was 2 to 38 years, with 93% including those between the age of 11 and 20 years old. Studies spanned 30 years (1993-2023) with 121 (64%) published in the last 10 years. Almost all (93%) were set-in high-income countries. We report 6 themes focusing on transition to adulthood: (1) I want to stay within the safety of home; (2) don't exclude me from my own care; (3) it might hurt but it's for my own good; (4) I rely on others but I want some independence; (5) I am no longer a child but I am not an adult yet; and (6) I wasn't prepared for the transfer to adult health care. Our findings focus on the complex transition into adulthood and the importance of creating a genuine healthcare partnership with young people by acknowledging their perspectives, creating a safe and supportive environment, and preparing them for the transition to adult pain care. Arts-based methods have the potential to make findings from qualitative evidence syntheses accessible and impactful for compassionate health care.
Personalised decision support in the management of patients with musculoskeletal pain in primary physiotherapy care: a cluster randomised controlled trial (the SupportPrim project)
Authors: Granviken Fredrik , Meisingset Ingebrigt , Bach Kerstin , Bones Anita Formo , Simpson Melanie Rae , Hill Jonathan C. , van der Windt Danielle A. , Vasseljen Ottar 
Published: October 2024

Abstract
We developed the SupportPrim PT clinical decision support system (CDSS) using the artificial intelligence method case-based reasoning to support personalised musculoskeletal pain management. The aim of this study was to evaluate the effectiveness of the CDSS for patients in physiotherapy practice. A cluster randomised controlled trial was conducted in primary care in Norway. We randomised 44 physiotherapists to (1) use the CDSS alongside usual care or (2) usual care alone. The CDSS provided personalised treatment recommendations based on a case base of 105 patients with positive outcomes. During the trial, the case-based reasoning system did not have an active learning capability; therefore, the case base size remained the same throughout the study. We included 724 patients presenting with neck, shoulder, back, hip, knee, or complex pain (CDSS; n = 358, usual care; n = 366). Primary outcomes were assessed with multilevel logistic regression using self-reported Global Perceived Effect (GPE) and Patient-Specific Functional Scale (PSFS). At 12 weeks, 165/298 (55.4%) patients in the intervention group and 176/321 (54.8%) in the control group reported improvement in GPE (odds ratio, 1.18; confidence interval, 0.50-2.78). For PSFS, 173/290 (59.7%) patients in the intervention group and 218/310 (70.3%) in the control group reported clinically important improvement in function (odds ratio, 0.41; confidence interval, 0.20-0.85). No significant between-group differences were found for GPE. For PSFS, there was a significant difference favouring the control group, but this was less than the prespecified difference of 15%. We identified several study limitations and recommend further investigation into artificial intelligence applications for managing musculoskeletal pain.