bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sociodemographic Influence on the Management of Orofacial Cleft in Urban and Rural Indonesia
Authors: Hasanuddin H. , Al-Jamaei Aisha AH. , Ruslin M. , Steijlen Fridus , Tajrin A. , Helder M. N. , Forouzanfar T. 
Published: October 2024

Objective To explore the social experiences of orofacial cleft patients and contextualize sociodemographic influence on management disparities in rural and urban areas of Indonesia. Design This study explores patients’ lives in two demographical settings in South Sulawesi Province, Makassar and Selayar Islands Regency. It employs ethnography, including open-ended interviews and observations of patients, their neighborhoods, schools, and workplaces. Secondary data from the two regencies and South Sulawesi province are employed to demonstrate demographic disparities in patient care between urban and rural areas. Thematic content analysis was performed according to socio-demographical differences and networks involved in the management. Participants This study engaged a diverse group of participants, including patients, family caregivers, medical team members, and patient peers (n = 40), primarily from middle to low-income families. Results Parents in both regions had limited knowledge about treatment modalities, which resulted in concerns regarding the safety of surgical procedures and the postponement of mandatory surgeries. In rural areas, patients faced significant financial burdens when referred to Makassar. In contrast to parents in Selayar, parents in Makassar prioritized more social interaction to ensure that their children attended school, college, and work. Patients in both settings reported facing various obstacles at different stages of their lives. Conclusions Sociodemographic conditions contribute to disparities in treatment, social positioning, and self-perception. Promoting education about the safety of medical and rural surgical procedures is vital. Involving patients in public activities and providing support from family caregivers is paramount to nurturing patients’ optimistic outlooks.
Safety of 3-month flushing interval for prevention of occlusion in totally implantable venous access ports: An analysis focused on intraluminal clots
Authors: Yang Woo Jin , Song Myung Gyu , Seo Tae-Seok , Kang Danbee , Park Sung-Joon , Kwak Jung Won 
Published: October 2024

Background: This study aimed to assess the safety and feasibility of a 3-month flushing interval for totally implantable venous access ports (TIVAPs), particularly regarding intraluminal clot formation. Methods: Between May 2017 and September 2018, we established a single-center cohort of 151 patients who were referred for TIVAP removal and categorized them into three flushing-interval groups: A (⩽1 month), B (1–2 months), and C (2–3 months). Odds ratios (OR) with 95% confidence intervals (CI) were computed using logistic regression to determine the risk of intraluminal clot occurrence. To compare clot lengths among the groups, we employed linear regression. Restricted cubic splines were used to model the flushing interval as a continuous variable. Results: Compared to Group A, Groups B and C had adjusted ORs of 0.82 (0.35–1.92) and 0.78 (0.29–2.11) for intraluminal clot risk. Occlusion was rare (1/151; 0.7%) and successfully treated with mechanical recanalization. Adjusted differences in clot length compared to Group A were 0.01 (−0.85 to 0.87) for Group B and −0.23 (−1.21 to 0.76) for Group C. Spline regression analysis showed no significant association between the flushing interval and clot length ( p for trend = 0.84). Conclusion: The incidence and burden of intraluminal clots did not increase significantly within the first 3 months. Occlusion was rare, even in the presence of clots, and was successfully treated. Therefore, a 3-month flushing interval appears to be a safe and practical option, aligning with the common recommendation for surveillance intervals in patients with cancer.
Seminal cell-free nucleic acids as possible biomarker in male infertility: a mini-review article
Authors: Javidmehr Davoud , Fesahat Farzaneh , Hassani Fatemeh , Talebi Ali Reza , Shahverdi Abdolhossein 
Published: October 2024

Abstract
Background
Male infertility is a major problem for many couples in the world. Many factors could cause male infertility such as environmental and genetic factors, life style, aging, inflammation, endocrinological etiologies, and antisperm antibodies.

Main body
Circulating cell-free nucleic acids (cfNAs) may play a key role in male infertility. cfNAs are obtained from different body fluids such as blood plasma, cerebrospinal fluid, amniotic fluid, urine, bronchoalveolar lavage fluid, and seminal plasma. The different types of cfNAs present in human semen include cell-free DNAs, cell free RNAs and cell-free mitochondrial DNAs and they are differentially higher than those in other body fluids. Few evidence have been done regarding the direct relationship between cfNAs and male infertility in serum and seminal plasma of infertile men compared to the fertile men.

Conclusions
This document aimed to compile data about the main causes influencing male infertility focusing on seminal cfNA/cfDNA and its possible role as differential biomarker to diagnosis the main source of spermatogenesis abnormalities and male infertility.
Exploring a GIS-based analytic hierarchy process for spatial flood risk assessment in Egypt: a case study of the Damietta branch
Authors: Zhran Mohamed , Ghanem Karim , Tariq Aqil , Alshehri Fahad , Jin Shuanggen , Das Jayanta , Pande Chaitanya Baliram , Pramanik Malay , Hasher Fahdah Falah Ben , Mousa Ashraf 
Published: October 2024

AbstractFloods are the most common and costly disasters worldwide, while spatial flood risk assessment is still challenging due to fewer observations and method limitations. In this study, the flood risk zonation in the Nile districts of the Damietta branch, Egypt, is delineated and assessed by integrating remote sensing with a geographic information system, and an analytical hierarchy process (AHP). Twelve thematic layers (elevation, slope, normalized difference vegetation index, topographic wetness index, modified normalized difference water index, topographic positioning index, stream power index, modified Fournier index, drainage density, distance to the river, sediment transport index, and lithology) are used for producing flood susceptibility zonation (FSZ) and six parameters (total population, distance to hospital, land use/land cover, population density, road density, and distance to road) are utilized for producing flood vulnerability zonation. Multicollinearity analysis is applied to identify highly correlated independent variables. Sensitivity studies have been used to assess the effectiveness of the AHP model. The results indicate that the high and very high flood risk classes cover 21.40% and 8.26% of the area, respectively. In 14.07%, 27.01%, and 29.26% of the research area, respectively, flood risk zones classified as very low, low, and moderate are found. Finally, FSZ is validated using the receiver operating characteristics curve and area under curve (AUC) analysis. A higher AUC value (0.741) in the validation findings demonstrated the validity of this AHP approach. The results of this study will help planners, hydrologists, and managers of water resources manage areas that are susceptible to flooding and reduce potential harm.
Correlation between the accuracy of the emergency response centre’s urgency assessment and emergency medical services non-conveyance: a retrospective register-based study in Finland
Authors: Salminen Tomi , Kaartinen Kaius , Palonen Mira , Setälä Piritta , Paavilainen Eija , Hoppu Sanna 
Published: October 2024

Abstract
Background
In modern emergency medical services (EMS), ambulances increasingly focus on examining and treating the patient at the scene. This has led to increased levels of non-conveyance. In Finland, for instance, approximately 40% of EMS dispatches end up in non-conveyance. As EMS systems evolve, the proportion of non-conveyance could serve as a cost-effective measure to assess the quality of the dispatch criteria, if a link to the performance of urgency assessment would be established. The purpose of this study was to investigate whether the proportion of non-conveyance is associated with the test performance levels of the urgency assessment. This investigation was done separately within each dispatch category.

Methods
A retrospective evaluation of the data was conducted on all EMS dispatches in the Pirkanmaa Hospital District from 1 August 2021 through 31 August 2021. There were a total of 7,245 EMS dispatches during the study period of which 829 were excluded. This study was conducted by comparing the existing test performance levels (sensitivity, specificity and under- or overestimation) of the emergency response centre’s urgency assessment with the non-conveyance rate (%) of each dispatch category. The relationships between the variables were measured using Spearman’s rank correlation coefficient.

Results
The proportion of over-triage was the only urgency assessment’s test performance variable that had a statistically significant correlation with the proportion of non-conveyance (r = 0.568; p = 0.003). Other test performance variables of the urgency assessment had no or little correlation to the proportion of non-conveyance. Of the 6,416 EMS dispatches in the study period, 42% (2,672) resulted in non-conveyance of the patient. In nine dispatch categories, at least half (51–69%) of the dispatches ended in non-conveyance.

Conclusions
Based on this study, it seems that the percentage of non-conveyance in the dispatch category could be used, with certain limitations, to assess the proportion of over-triage in the dispatch category. The method is particularly applicable in scenarios where the dispatch criteria have undergone modifications and there is a need to monitor the effect of the changes on the level of over-triage.
Barriers and facilitators to providing rehabilitation for long-term care residents with dementia: a qualitative study
Authors: Ibekaku Michael Chigozie , Ripley Sara , Alizadehsaravi Niousha , Affoo Rebecca , Middleton Laura E. , Moody Elaine , Ghanouni Parisa , Weeks Lori E. , McArthur Caitlin 
Published: October 2024

Abstract
Background
Rehabilitation can help long-term care (LTC) residents with dementia maintain their independence. However, many residents do not receive rehabilitation. This study aimed to identify the barriers and facilitators to providing rehabilitation for LTC residents with dementia and propose practical interventions for overcoming them.

Methods
Using a phenomenological research design, we conducted a qualitative study involving 17 privately owned LTC homes in Nova Scotia, Canada. Data were collected through individual interviews and a focus group with residents with dementia (n = 3), family members (n = 4), rehabilitation providers (n = 6), and other staff (n = 3). We analyzed the data using inductive thematic content analysis and mapped the results onto the socioecological framework and the Behaviour Change Wheel (BCW) to classify and analyze barriers and facilitators to rehabilitation. The APEASE criteria (Acceptability, Practicability, Effectiveness, Affordability, Side-effects, and Equity) in the BCW were used to identify feasible interventions and policies linked to the identified barriers and facilitators.

Results
Barriers at the intrapersonal level included communication difficulties, comorbidities, and lack of motivation among residents. Interpersonal factors encompassed the availability of family support and lack of interdisciplinary practice. Policy/environmental factors involved limited resources, complex admission processes, low staff ratios, and restrictive restraint policies. Enhancing communication, reducing the use of restraints, promoting interdisciplinary practice, and increasing accessibility to activity spaces and equipment will improve the provision of rehabilitation for the residents.

Conclusion
Enhancing the capabilities, opportunities, and motivations of all actors in LTC homes can potentially minimize these barriers. Interventions such as staff training on effective communication and dementia care, promoting person-centred and meaningful activities, and improving interdisciplinary collaboration are crucial. Policy measures to improve hospital-to-LTC transitions, increase volunteer involvement, educate families and communities, and recruit more staff are recommended. Addressing these barriers through targeted interventions and policy changes can significantly improve rehabilitation provision for residents with dementia in LTC settings.
Retinol-binding protein type 1 expression predicts poor prognosis in head and neck squamous cell carcinoma
Authors: Fu Ling-ling , Yan Ming , Yu Xin , Shao Min , Gosau Martin , Friedrich Reinhard E. , Vollkommer Tobias , Smeets Ralf , Feng Hong-chao , Xu Liya 
Published: October 2024

Abstract
Background
Head and neck squamous cell carcinoma (HNSCC) is the sixth most prevalent malignancy worldwide, with high incidence and poor survival rates. RBP1 is highly expressed in several kinds of cancer and plays a potential prognostic factor. However, the relationship between RBP1 and HNSCC were analyzed based on The Cancer Genome Atlas (TCGA) database.

Materials and methods
RBP1 expression and clinical information were obtained from the Cancer Genome Atlas (TCGA) database. Tumor tissue and adjacent normal tissue of 6 HNSCC patients were collected to analyze the RBP1 mRNA expression level by quantitative PCR. Cox regression analysis was used to evaluate the prognostic values of RBP1 and clinical data in HNSCC. A nomogram was also established to predict the impact of RBP1 on prognosis based on Cox multivariate results. The methylation level of RBP1 in HNSC and its prognosis were analyzed in UALACN and MethSurv. Finally, the potential biological functions of RBP1 were investigated using gene set enrichment analysis (GSEA) and single sample GSEA (ssGSEA).

Results
The mRNA expression levels of RBP1 were highly expressed in HNSCC tissue. The Cox analyses demonstrate that highly-expressed RBP1 is an independent prognosis marker(P < 0.05). ROC curve analysis showed that performances of RBP1 (area under the ROC curve: 0.887, sensitivity: 84.1%, specificity: 79.9%). The methylation was increased in HNSCC patients compared with normal subjects(P < 0.05) and was associated with better prognosis at sites cg06208339, cg12298268, cg12497564, cg15288618, cg20532370, cg23448348. Additionally, RBP1 expression is mildly associated with immune cell infiltration and immunological checkpoints.

Conclusion
RBP1 is overexpressed and associated with poor patient prognosis in head and neck squamous cell carcinoma.
Multiple cytokine analysis of aqueous humor in uveitis with or without secondary glaucoma
Authors: Xiao Junyan , Zhao Chan , Cheng Gangwei , Song Hang , Zhang Yang , Zhang Meifen 
Published: October 2024

AbstractTo assess the level of both pro-inflammatory and anti-inflammatory cytokines in the aqueous humor (AH) of patients suffering from uveitis, with or without coexisting glaucoma, and compare them with patients diagnosed with primary open-angle glaucoma (POAG) and those with age-related cataract (ARC). By using Luminex xMAP® multiplex assays analyses, we assessed levels of 11 cytokines and chemokines, and compared them across groups, including uveitis-secondary glaucoma (USG) (n = 16), uveitis without glaucoma (UwoG), (n = 16), POAG (n = 16), and ARC (n = 16) to explore the correlation between these cytokines and the presence of uveitis, as well as intraocular pressure (IOP). Pro-inflammatory factors MCP-1, MIP-1β, IL-6, IL-8, and transforming growth factors TGF-β1 and TGF-β2 were significantly elevated in the AH of USG eyes. In the case of enhanced anti-inflammatory in the perioperative period, the pro-inflammatory factors remained notably elevated in the USG group compared to the UwoG group (P < 0.01). The levels of IL-6, IL-8, and MCP-1 in the AH of the USG group and POAG group had the same trend, which markedly surpassed those of the ARC group (P < 0.01). Significantly increased levels of MCP-1, MIP-1β, IL-6, IL-8, TGF-β1, and TGF-β2 were found in the AH of USG patients, implying a potential role for these mediators in the progression of glaucomatous manifestations within patients with uveitis. Besides the analysis revealed no discernible statistical disparity in cytokine concentrations within the AH of USG eyes whether the preoperative baseline IOP was greater than 30 mmHg or not, indicating that the safety of antiglaucoma surgery in USG patients even with baseline high IOP.
Individualised computerised cognitive training (iCCT) for community-dwelling people with mild cognitive impairment (MCI): results on cognition in the 6-month intervention period of a randomised controlled trial (MCI-CCT study)
Authors: Graessel Elmar , Jank Michael , Scheerbaum Petra , Scheuermann Julia-Sophia , Pendergrass Anna 
Published: October 2024

Abstract
Background
Computerised cognitive training (CCT) can improve the cognitive abilities of people with mild cognitive impairment (MCI), especially when the CCT contains a learning system, which is a type of machine learning (ML) that automatically selects exercises at a difficulty that corresponds to the person’s peak performance and thus enables individualised training.

Methods
We developed one individualised CCT (iCCT) with ML and one basic CCT (bCCT) for an active control group (CG). The study aimed to determine whether iCCT in the intervention group (IG) resulted in significantly greater enhancements in overall cognitive functioning for individuals with MCI (age 60+) compared with bCCT in the CG across a 6-month period. This double-blind randomised controlled study was conducted entirely virtually. The 89 participants were community-dwelling people with a psychometric diagnosis of MCI living in Germany. The iCCT stimulates various cognitive functions, especially working memory, visuo-constructional reasoning, and decision-making. The bCCT includes fewer and simpler tasks. Both CCTs were used at home. At baseline and after 6 months, we assessed cognitive functioning with the Montreal Cognitive Assessment (MoCA). A mixed-model ANCOVA was conducted as the main analysis.

Results
Both CCTs led to significant increases in average global cognition. The estimated marginal means of the MoCA score increased significantly in the CG by an average of 0.9 points (95% CI [0.2, 1.7]) from 22.3 (SE = 0.25) to 23.2 (SE = 0.41) points (p = 0.018); in the IG, the MoCA score increased by an average of 2.2 points (95% CI [1.4, 2.9]) from 21.9 (SE = 0.26) to 24.1 (SE = 0.42) points (p < 0.001). In a confound-adjusted multiple regression model, the interaction between time and group was statistically significant (F = 4.92; p = 0.029). The effect size was small to medium (partial η2 = 0.057). On average, the participants used the CCTs three times per week with an average duration of 34.9 min per application. The iCCT was evaluated as more attractive and more stimulating than the bCCT.

Conclusions
By using a multi-tasking CCT three times a week for 30 min, people with MCI living at home can significantly improve their cognitive abilities within 6 months. The use of ML significantly increases the effectiveness of cognitive training and improves user satisfaction.

Trial registration
ISRCTN14437015; registered February 27, 2020.
Trajectories of triglyceride-glucose index changes and their association with all-cause and cardiovascular mortality: a competing risk analysis
Authors: Lee Jun-Hyuk , Jeon Soyoung , Lee Hye Sun , Lee Ji-Won 
Published: October 2024

Abstract
Background
The association between changes in insulin resistance, reflected by the triglyceride-glucose (TyG) index, and mortality remains unclear. This study investigated whether longitudinal trajectories of TyG index changes are associated with all-cause and cardiovascular disease (CVD) mortality.

Methods
This retrospective cohort study analyzed data from 233,546 adults aged ≥ 19 years from the Korea National Health Insurance Service-National Sample Cohort. Participants were categorized as having increasing, stable, or decreasing TyG index changes during a 4-year exposure period (2009–2014). Mortality outcomes were assessed during an 8.13-year follow-up period (2015–2021). Cox proportional hazards regression and competing risk analysis were used to evaluate all-cause and CVD mortality.

Results
A total of 7918 mortality events, including 651 CVD deaths, were recorded. Compared with the stable group, adjusted hazard ratios for all-cause mortality were 1.09 (95% CI 1.03–1.15) in the increasing group and 1.23 (95% CI 1.01–1.50) for CVD mortality. An increased TyG index was significantly associated with all-cause mortality in individuals aged < 50 years; men; and individuals with obesity, hypertension, diabetes, and/or dyslipidemia. For CVD mortality, significant associations were found in individuals aged 50–69 years, with obesity, with diabetes, or without dyslipidemia.

Conclusion
An increasing TyG index from baseline during follow-up was independently associated with higher risks of all-cause and CVD mortality. Serial monitoring of TyG index changes could enhance risk stratification and inform targeted interventions to reduce insulin resistance, and ultimately lower mortality risk.
Nanoplatelets modified with RVG for targeted delivery of miR-375 and temozolomide to enhance gliomas therapy
Authors: Yang Tingting , Zhang Nan , Liu Yuanyuan , Yang Ruyue , Wei Zhaoyi , Liu Futai , Song Dan , Wang Longwei , Wei Jiangyan , Li Yuanpei , Shen Deliang , Liang Gaofeng 
Published: October 2024

AbstractGliomas are one of the most frequent primary brain tumors and pose a serious threat to people’s lives and health. Platelets, a crucial component of blood, have been applied as drug delivery carriers for disease diagnosis and treatment. In this study, we designed engineered nanoplatelets for targeted delivery of therapeutic miR-375 and temozolomide (TMZ, a first-line glioma treatment agent) to enhance glioma therapy. Nanoplatelets were prepared through mild ultrasound, TMZ and miR-375 were co-loaded through ultrasound and electrostatic interactions, respectively, to combine chemotherapy with gene therapy against glioma. To improve the blood brain barrier (BBB) crossing efficiency and glioma targeting ability, the nanoplatelets were modified with central nervous system-specific rabies viral glycoprotein peptide (RVG) through thiol-maleimide click reaction. The RVG modified nanoplatelets co-loaded TMZ and miR-375 (NR/TMZ/miR-375) not only inherited the good stability and remarkable biocompatibility of platelets, but also promoted the cellular uptake and penetration of glioma tissues, and effectively induced cell apoptosis to enhance the therapeutic effect of drugs. In vivo studies showed that NR/TMZ/miR-375 significantly increased the circulation time of TMZ, and exhibited superior combined antitumor effects. In summary, this multifunctional ‘natural’ nanodrug delivery system provides a potent, scalable, and safety approach for platelet-based combined cancer chemotherapy and gene therapy.