bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bridging the gap: a qualitative process evaluation from the perspectives of healthcare professionals of an audit-and-feedback-based intervention to improve transition to adult care for young people living with type 1 diabetes
Authors: Parsons Janet A. , Wigle Jannah , Zenlea Ian , Ivers Noah , Mukerji Geetha , Landry Alanna , Punthakee Zubin , Clarson Cheril L. , Shulman Rayzel 
Published: October 2024

Abstract
Background
The transition from pediatric to adult care is a vulnerable time for young people living with type 1 diabetes (T1D). Bridging the Gap (BTG) is an audit-and-feedback (AF) intervention aimed at improving both transitions-in-care processes and diabetes management in the year following transition. As part of BTG, we conducted a qualitative process evaluation to understand: (a) what was implemented and how; and (b) the contextual factors (micro-, meso- and macro-) that affected implementation, outcomes and study processes.

Methods
Using qualitative descriptive methodology, interviews were conducted with 13 healthcare professionals (HCPs) delivering diabetes care to transitioning youth. Participants were asked about their experiences of BTG study processes and feedback tools, the quality improvement (QI) initiatives implemented at their site, and potential spread and scale. Interviews also explored the impacts of COVID-19 on transition care and study processes and results.

Results
Five key themes were identified. Participants’ reflections on the BTG study design indicated they appreciated its flexible, site-specific approach to QI, which they saw as crucial to the success of their initiatives. Engagement with feedback reports and other study resources provided comparative, site-specific data. Participants described the challenges posed by the COVID-19 pandemic and its impacts on patients, care provision and study implementation. Their site-specific QI initiatives resulted in changes to their transition practices. Finally, participants commented on how BTG and its processes fostered a community of practice (CoP) between sites, resulting in new opportunities to collaborate and share experiences.

Conclusions
BTG resulted in a CoP among practitioners delivering transition care to youth with T1D, which could be scaled up to promote a learning health system in pediatric diabetes care. Qualitative process evaluation is a useful tool for understanding how contextual factors affect the implementation and outcomes of complex QI interventions.
The renoprotective efficacy and safety of genetically-engineered human bone marrow-derived mesenchymal stromal cells expressing anti-fibrotic cargo
Authors: Li Yifang , Hunter Alex , Wakeel Miqdad M. , Sun Guizhi , Lau Ricky W. K. , Broughton Brad R. S. , Pino Ivan E. Oyarce , Deng Zihao , Zhang Tingfang , Murthi Padma , Del Borgo Mark P. , Widdop Robert E. , Polo Jose M. , Ricardo Sharon D. , Samuel Chrishan S. 
Published: October 2024

Abstract
Background
Kidney fibrosis is a hallmark of chronic kidney disease (CKD) and compromises the viability of transplanted human bone marrow-derived mesenchymal stromal cells (BM-MSCs). Hence, BM-MSCs were genetically-engineered to express the anti-fibrotic and renoprotective hormone, human relaxin-2 (RLX) and green fluorescent protein (BM-MSCs-eRLX + GFP), which enabled BM-MSCs-eRLX + GFP delivery via a single intravenous injection.

Methods
BM-MSCs were lentiviral-transduced with human relaxin-2 cDNA and GFP, under a eukaryotic translation elongation factor-1α promoter (BM-MSCs-eRLX + GFP) or GFP alone (BM-MSCs-eGFP). The ability of BM-MSCs-eRLX + GFP to differentiate, proliferate, migrate, produce RLX and cytokines was evaluated in vitro, whilst BM-MSC-eRLX + GFP vs BM-MSCs-eGFP homing to the injured kidney and renoprotective effects were evaluated in preclinical models of ischemia reperfusion injury (IRI) and high salt (HS)-induced hypertensive CKD in vivo. The long-term safety of BM-MSCs-RLX + GFP was also determined 9-months after treatment cessation in vivo.

Results
When cultured for 3- or 7-days in vitro, 1 × 106 BM-MSCs-eRLX + GFP produced therapeutic RLX levels, and secreted an enhanced but finely-tuned cytokine profile without compromising their proliferation or differentiation capacity compared to naïve BM-MSCs. BM-MSCs-eRLX + GFP were identified in the kidney 2-weeks post-administration and retained the therapeutic effects of RLX in vivo. 1–2 × 106 BM-MSCs-eRLX + GFP attenuated the IRI- or therapeutically abrogated the HS-induced tubular epithelial damage and interstitial fibrosis, and significantly reduced the HS-induced hypertension, glomerulosclerosis and proteinuria. This was to an equivalent extent as RLX and BM-MSCs administered separately but to a broader extent than BM-MSCs-eGFP or the angiotensin-converting enzyme inhibitor, perindopril. Additionally, these renoprotective effects of BM-MSCs-eRLX + GFP were maintained in the presence of perindopril co-treatment, highlighting their suitability as adjunct therapies to ACE inhibition. Importantly, no major long-term adverse effects of BM-MSCs-eRLX + GFP were observed.

Conclusions
BM-MSCs-eRLX + GFP produced greater renoprotective and therapeutic efficacy over that of BM-MSCs-eGFP or ACE inhibition, and may represent a novel and safe treatment option for acute kidney injury and hypertensive CKD.
Empirical challenges in assessing the “leaky STEM pipeline”: how the research design affects the measurement of women’s underrepresentation in STEM
Authors: Stefani Antje , Minor Ralf , Leuze Kathrin , Strauss Susanne 
Published: October 2024

Abstract
Background
Despite a well-documented underrepresentation of women in STEM majors and occupations, empirical evidence on whether there really is a “leaky STEM pipeline” is mixed due to a lack of methodological consistency. Studies vary by (1) the definition of STEM, (2) the decision to measure choices alone or to also include aspirations, and (3) the use of longitudinal or cross-sectional data.

Results
In order to analyze how variations in the research design affect the measurement of women’s underrepresentation in the field of STEM, we critically reviewed relevant literature on the “leaky pipeline” and identified three central features in the designs of existing empirical studies. We illustrate how the variation of these affects the results by applying them to the German context. Our results support the “leakage” perspective for Germany only during the transition to the labor market. Changes in STEM aspirations between grades 9 and 12 do not follow a clear pattern. Indeed, a comparison of grade 12 aspirations to actual college major choices even shows an increasing share of women in STEM.

Conclusion
Germany does not exhibit a significant “leaky STEM pipeline”. Due to more men choosing STEM, gender gaps widen in higher education, while the pipeline remains stable. Therefore, we challenge the “leaky pipeline” metaphor, advocating a life-course perspective to better understand STEM trajectories. We call for refined measurement standards, emphasizing official STEM definitions, long-term observations from aspirations to career entry, and the use of longitudinal data.
An aggressive gastric CIC-DUX4 sarcoma surgically resected with multivisceral organs: a case report
Authors: Koba Mizuki , Takeno Atsushi , Hasegawa Hiroko , Sakamori Ryotaro , Higashiura Rei , Yamamoto Masaaki , Tokuyama Shinji , Toshiyama Reishi , Kawai Kenji , Takahashi Yusuke , Sakai Kenji , Hama Naoki , Gotoh Kunihito , Kato Takeshi , Hirose Yumiko , Mori Kiyoshi , Mano Masayuki , Hirao Motohiro 
Published: October 2024

Abstract
Background
Capicua transcriptional repressor-double homeobox 4 sarcoma (CDS) is a rare and aggressive malignant soft tissue tumor that typically arises within the soft tissues. We report an exceptionally rare case of a gastric CDS successfully resected despite its extensive invasion into surrounding organs.

Case presentation
A 48-year-old male presented with a progressively enlarging abdominal mass. Upper gastrointestinal endoscopy revealed a large ulcerative tumor on the posterior gastric wall. Biopsy results initially suggested a neuroendocrine cell carcinoma. Contrast-enhanced computed tomography showed a 20 cm tumor protruding from the posterior stomach wall, directly invading the pancreas and colon. We performed a multivisceral resection (stomach, pancreatic tail, spleen, and transverse colon) achieving an R0 resection. Pathological examination of the permanent specimen revealed small round cells with high nuclear-to-cytoplasmic ratios. Immunohistochemical staining confirmed the diagnosis of CDS. The patient recovered well and was discharged on postoperative day 33.

Conclusions
This case report describes the first detailed account of a surgically resected aggressive CDS originating from the stomach.
Ruptured solitary fibrous tumor of the pleura with hemothorax: a case report
Authors: Komatsu Hiroaki , Furukawa Nao , Imamoto Kosuke , Okabe Kazunori 
Published: October 2024

Abstract
Background
The majority of the patients with a solitary fibrous tumor (SFT) of the pleura are asymptomatic, and rupture of an SFT with hemothorax is rare.

Case presentation
A 48-year-old man was taken by ambulance to our hospital because of sudden onset of left chest pain. Two months before the referral, a tumor was detected in the left upper lobe of the lung by screening computed tomography at another hospital, and further observation was recommended, because the tumor was suspected to be benign. Our contrast-enhanced computed tomography analysis of the chest revealed a solid tumor (5 cm in diameter) with an irregular enhancement effect close to the pericardium and pleural effusion in the left thoracic cavity. Pleural effusion was not detected in the previous imaging analysis. CT number of the pleural effusion was 40 HU, and the pleural effusion was suspected to be hematogenous. Therefore, rupture of the tumor with bleeding was suspected as the cause of the effusion because of the sudden onset. Preoperative diagnosis was a mediastinal tumor, such as a teratoma, because the tumor was close to the pericardium. Thoracoscopic surgery was performed with the patient in the right lateral decubitus position; bloody pleural effusion was observed and drained. The tumor originated from the visceral pleura of the left upper lobe of the lung and was resected with a surgical stapler. Macroscopic analyses of the resected tumor indicated that bleeding were caused by the rupture of the tumor at the defect of the capsule wall. The operation took 63 min. The postoperative pathological diagnosis was a benign SFT. Hemorrhage was observed just under the capsule wall of the tumor. The postoperative course of the patient was uneventful, and he was discharged 2 days after surgery.

Conclusions
Even when an SFT is neither huge nor malignant, rupture can occur, and resection should be considered regardless of the size or malignant characteristics. After an SFT rupture, careful follow-up is needed to monitor for the intrathoracic recurrence or dissemination of the tumor.
Fine Tuning ECG Interpretation for Young Athletes: ECG Screening Using Z-score-based Analysis
Authors: Park Jihyun , Kimata Chieko , Young Justin , Perry James C. , Bratincsak Andras 
Published: October 2024

Abstract
Background
Electrocardiograms (ECGs) in athletes commonly reveal findings related to physiologic adaptations to exercise, that may be difficult to discern from true underlying cardiovascular abnormalities. North American and European societies have published consensus statements for normal, borderline, and abnormal ECG findings for athletes, but these criteria are not based on established correlation with disease states. Additionally, data comparing ECG findings in athletes to non-athlete control subjects are lacking. Our objective was to compare the ECGs of collegiate athletes and non-athlete controls using Z-scores for digital ECG variables to better identify significant differences between the groups and to evaluate the ECG variables in athletes falling outside the normal range.

Methods
Values for 102 digital ECG variables on 7206 subjects aged 17–22 years, including 672 athletes, from Hawaii Pacific Health, University of Hawaii, and Rady Children’s Hospital San Diego were obtained through retrospective review. Age and sex-specific Z-scores for ECG variables were derived from normal subjects and used to assess the range of values for specific ECG variables in young athletes. Athletes with abnormal ECGs were referred to cardiology consultation and/or echocardiogram.

Results
Athletes had slower heart rate, longer PR interval, more rightward QRS axis, longer QRS duration but shorter QTc duration, larger amplitude and area of T waves, prevalent R’ waves in V1, and higher values of variables traditionally associated with left ventricular hypertrophy (LVH): amplitudes of S waves (leads V1-V2), Q waves (V6, III) and R waves (II, V5, V6). Z-scores of these ECG variables in 558 (83%) of the athletes fell within − 2.5 and 2.5 range derived from the normal population dataset, and 60 (8.9%) athletes had a Z-score outside the − 3 to 3 range. While 191 (28.4%) athletes met traditional voltage criteria for diagnosis of LVH on ECG, only 53 athletes (7.9%) had Z-scores outside the range of -2.5 to 2.5 for both S amplitude in leads V1-V2 and R amplitude in leads V5-6. Only one athlete was diagnosed with hypertrophic cardiomyopathy with a Z-score of R wave in V6 of 2.34 and T wave in V6 of -5.94.

Conclusion
The use of Z-scores derived from a normal population may provide more precise screening to define cardiac abnormalities in young athletes and reduce unnecessary secondary testing, restrictions and concern.
Assessing the impact of migration on the happiness of household women left behind: evidence from Punjab, Pakistan
Authors: Aziz Noshaba , Raza Ali , Yang Shaoxiong , Zhou Jin 
Published: October 2024

AbstractThe concept of happiness is becoming an increasingly significant area of focus in the evaluation of overall quality of life. This research examines the impact of migration on the well-being of women who remain in their place of residence following the migration of their family members. The study employs data from the Multiple Indicators Cluster Survey (2017–2018) in Punjab, Pakistan, and addresses sample selection bias through Propensity Score Matching (PSM). Moreover, as the dependent variable is ordinal, the study employed ordered logistic regression to examine the correlation between migration and happiness, taking into account migration status and other variables. The findings indicate that women from migrant backgrounds tend to benefit from migrating, primarily in terms of enhanced financial resources. In order to gain insight into the varying effects of migration on women’s happiness, the study employed heterogeneity analysis, which revealed that the influence of migration on women’s happiness differs across various areas. In conclusion, the combination of propensity score matching (PSM) with ordered logistic regression and heterogeneity analysis represents a robust methodology for evaluating the impact of migration on women’s perceptions of happiness. The study demonstrates that migration has the potential to improve the quality of life of women who remain in their home countries, particularly those residing in financially disadvantaged households.
A community-centric model for conference co-creation: the world conference on CDG for patients, families and professionals
Authors: Francisco Rita , Pascoal Carlota , Granjo Pedro , de Freitas Claudia , Videira Paula A. , dos Reis Ferreira Vanessa 
Published: October 2024

Abstract
Background
Patient and public co-creation and involvement in health initiatives have been witnessing great expansion in recent years. From healthcare to research settings, collaborative approaches are becoming increasingly prevalent and diverse, especially in the field of rare diseases which faces complex challenges. Conference development and implementation, however, have been primarily guided by passive, information-sharing models. There is a need for conferences to evolve towards more inclusive, interactive, collaborative, and problem-solving platforms. Here, we aimed to report on a pioneer model, emphasizing a community partnership approach to conference co-creation that takes the World Conference on Congenital Glycosylation Disorders (CDG) as an exemplary case.

Methods
To answer the need to overcome the lack of access to high-quality information which limits CDG diagnosis, research and treatment options, the World CDG Organization has been refining a community-centric model for conference co-creation. Focusing on the 5th edition of the conference, data on stakeholders’ preferences was collected using an online survey and a poll to define the conference agenda, guide its development and select optimal dates for an all-stakeholder inclusive, relevant and participatory event.

Results
We describe the complexities of the community-centric conference co-creation model, detailing its refined methodology and the outcomes achieved. The model is grounded on a participative approach to promote people-centered research and care for CDG patients. The involvement of the public in the conference co-creation and in participatory methods allowed the generation of knowledge on community needs and preferences.

Conclusion
This paper describes a reliable, highly adaptable conference co-creation model that fosters community-building, disseminates understandable information, and serves as a borderless platform to incentivize multiple stakeholder collaborations towards CDG research and drug development. We argue this is a reproducible model that can be endorsed and more widely adopted by other disease communities and events.
Gochujang, a Korean traditional fermented soybean product: history, preparation and functionality
Authors: Jung Su-Jin , Shin Dong-Hwa 
Published: October 2024

AbstractKorean food has garnered global interest, especially after COVID-19, with a significant increase in demand for K-Food staples like bulgogi, tteokbokki, bibimbap, kimchi, and galbi, as well as related YouTube content. A key ingredient that enhances the deliciousness of Korean cuisine is Gochujang. Gochujang, with its unique taste and aroma, is an unparalleled fermented spice seasoning, adding spiciness and a special flavor to a variety of dishes. Made from ingredients such as Meju, glutinous rice, red pepper powder, malt, and salt, Gochujang has a rich history spanning thousands of years and is celebrated for its spicy and sweet flavor. Gochujang is differentiated by commercial and traditional manufacturing methods. Traditional Gochujang is produced through natural fermentation using glutinous rice, malt, Meju powder, salt, and red pepper powder. Conversely, commercial production blends traditional methods with modern industrial techniques, utilizing pure microbial cultures like Aspergillus oryzae and Bacillus subtilis as starters to meet mass production demands. Beyond its culinary uses, Gochujang is recognized globally for its nutritional value and health benefits. Fermentation enhances its health functionality by creating new substances or converting fermentation metabolites. Notable compounds synthesized during fermentation include capsaicin from red pepper powder and non-glycoside isoflavones from Meju, which are linked to antiobesity, antidiabetic, antiatherosclerosis, and anticancer effects. Gochujang also helps restore intestinal microbial balance, promoting gut health. This review aims to explore the historical background of Gochujang, its production methods, flavor characteristics, nutritional composition, health benefits, and the expansion of culinary research involving Gochujang.
Prevalence and associated factors of suicide-related behaviors in Iranian students: a large sample cross-sectional study
Authors: Yaghubi Hamid , Soleimani Leila , Abedi Yarandi Mohammad Saeed , Mollaei Aghil , Mahdavinoor Seyyed Muhammad Mahdi 
Published: October 2024

Abstract
Background
Admission to the university changes life conditions and thereby increases mental pressure. If the students cannot bear the psychological pressure of being a student, that may lead to suicide among the vulnerable persons. Therefore, in this research, we would like to investigate the prevalence and associated factors of suicide-related behaviors in Iranian students.

Methods
This online, cross-sectional survey was performed from March 18 to April 15, 2023, in Iran. The questionnaires were completed by 2181 students. In this study, Perceived Stress Scale (PSS-4), Meaning in Life Questionnaire (MLQ), Generalized Anxiety Disorder Scale (GAD-7), and Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Oslo Social Support Scale (OSSS-3) were used. Finally, we identified the factors associated with suicide-related behaviors using univariate and multiple regression.

Results
The prevalence of suicidal behaviors in students was 57.95%. According to the results, male gender, marriage, having meaning in life, occasional smoking, sleeping after 1 a.m., and having social support were associated with a reduced risk of suicide. In addition, a history of sexual abuse, more anxiety, and higher perceived stress were associated with an increased risk of suicide.

Conclusions
The prevalence of suicide-related behaviors in Iranian students was higher than expected. Urgent interventions should be considered to prevent students from committing suicide. Helping students find meaning in life, as well as eliminating the causes of students’ anxiety and stress, may be effective in this respect. Additionally, teaching students how to control anxiety and stress may be helpful.
Elevated 1-hour Post Load Glucose as a Predictor for Telomere Attrition: A Study Based on a Chinese Community Population
Authors: Gao Qi , Yu Jie , Liu Yiwen , Xing Baodi , Ping Fan , Xu Lingling , Li Wei , Zhang Huabing , Li Yuxiu 
Published: October 2024

Abstract

Context
One-hour post-load glucose (1h-PG) detects dysglycemia-related disorders more effectively than traditional glycemic parameters. Hyperglycemia accelerates aging, but whether 1h-PG outperforms in predicting aging remains unclear.

Objective
To compare the effectiveness of 1h-PG with other glycemic parameters in identifying and predicting telomere attrition.

Methods
We conducted a cross-sectional and longitudinal study based on a Chinese community cohort. Multivariate linear regression and logistic regression were used to analyze the associations between glycemic parameters and telomere length. The area under the receiver operating characteristic (AUROC) curve were used to compare the differentiating and predictive ability. Populations were regrouped by glucose tolerance status and 1h-PG to compare telomere length. Analyses were separately conducted in nondiabetic and diabetic populations.

Results
The cross-sectional study included 715 participants. Only 1h-PG was significantly negatively associated with relative telomere length in both nondiabetic [β = −.106, 95% confidence interval (CI) −0.068 to −0.007, P = .017] [odds ratio (OR) = 1.151, 95% CI 1.069 to 1.239, P = .005] and diabetic (β = −.222, 95% CI −0.032 to −0.007, P = .002) (OR = 1.144, 95% CI 1.041 to 1.258, P = .035) populations. The longitudinal study recruited 437 populations and 112 remained in 7-years follow-up. 1h-PG was associated with telomere shortening in the nondiabetic group (β = −.314, 95% CI −0.276 to −0.032, P = .016) (OR = 2.659, 95% CI 1.158 to 6.274, P = .021). AUROC analysis showed that 1h-PG outperformed other glycemic parameters in identifying and predicting telomere attrition. Reclassification revealed that normal glucose tolerance and prediabetic individuals with elevated 1h-PG had telomere lengths comparable to prediabetic and diabetic populations, respectively.

Conclusion
1h-PG outperforms other glycemic parameters in predicting telomere attrition and can be a valuable marker for early aging detection.