bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive factors associated with health-related quality of life in patients with colorectal cancer in Iran: a cross-sectional study
Authors: Dahouri Amirmohammad , Sahebihagh Mohammad Hasan , Gilani Neda 
Published: September 2024

ObjectivesThis study aims to identify the primary factors influencing health-related quality of life (HRQoL) in patients with colorectal cancer (CRC), hypothesising that specific patient characteristics and clinical factors significantly impact HRQoL.DesignThis was a cross-sectional study conducted over 1 month, from 1 April 2022 to 1 May 2022.SettingThe study was conducted in five hospitals in the northwest region of Iran, focusing on outpatient chemotherapy services.ParticipantsA total of 251 patients diagnosed with colon and rectal cancer participated in the study. Inclusion criteria included a confirmed diagnosis by an oncologist, ability to communicate, willingness to participate and being aware of their diagnosis and treatment. Exclusion criteria were the presence of other chronic diseases, cognitive disorders, known mental disorders and unwillingness to participate.InterventionsNo interventions were applied as this was an observational study.Primary and secondary outcome measuresThe primary outcome was the HRQoL of patients with CRC, measured using a standardised SF-36 (36-Item Short Form Health Survey) questionnaire. Secondary outcomes included the impact of demographic and clinical factors on HRQoL.ResultsThe total score of HRQoL in these patients is 47.22±16.78, which indicates that HRQoL is disturbed in these patients. Also, the results of the stepwise multiple regression revealed that among all the participants’ characteristics considered, seven factors: not having another disease besides cancer (p<0.001, β: 12.91, 95% CI 8.40, 17.42), only receiving chemotherapy (p<0.001, β: 9.10, 95% CI 4.12, 14.09), not having colostomy (p<0.001, β: 10.27, 95% Cl 5.70, 14.84), female sex (p=0.046, β: −4.52, 95% Cl −8.95, –0.08), living in their own house (p=0.001, β: 11.25, 95% Cl 4.77, 17.73), living in city (p=0.002, 17.74, 95% Cl 6.51, 28.96) and finally not having a job (p=0.003, β: −7.47, 95% Cl −12.31, –2.63), including are the factors that have the most predictive power in HRQoL.ConclusionsThe findings of this study encourage health service providers and planners to pay special attention to the characteristics of patients with CRC as identified in this study. Notably, several HRQoL scores in patients with CRC are low, and the study found that patient characteristics, such as the presence of colostomy, unemployment, female gender and comorbidities, significantly predict the overall HRQoL score. Future research should focus on interventional studies aimed at minimising the adverse effects of disease symptoms on HRQoL in these vulnerable patients.
Health professionals’ and caregivers’ perspectives on improving paramedics’ provision of palliative care in Australian communities: a qualitative study
Authors: Juhrmann Madeleine , Butow Phyllis , Platts Cara , Boughey Mark , Simpson Paul , Clayton Josephine M 
Published: September 2024

ObjectivesParamedics have the potential to make a substantial contribution to community-based palliative care provision. However, they are hindered by a lack of policy and institutional support, as well as targeted education and training. This study aimed to elicit paramedics’, palliative care doctors’ and nurses’, general practitioners’, residential aged care nurses’ and bereaved families and carers’ attitudes and perspectives on how palliative paramedicine can be improved to better suit the needs of community-based patients, their families and carers, and the clinicians involved in delivering the care.DesignIn this qualitative study underpinned by a social constructivist epistemology, semistructured interviews were conducted.Setting and participants50 participants with palliative paramedicine experience, from all jurisdictions of Australia. Participants were interviewed between November 2021 and April 2022.ResultsAll participants suggested paramedics play an important adjunct role in the provision of palliative and end-of-life care in home-based settings. Three levels of opportunities for improvement were identified: macrolevel (policy and frameworks; funding and education; accessing medical records and a widening scope); mesolevel (service-level training; interprofessional understanding and communities of practice and community expectations) and microlevel (palliative care subspecialty; debriefing and self-care and partnering with families).ConclusionTo enhance paramedic capacity to provide palliative care support, improvements targeting systems, services, communities and individuals should be made. This calls for stronger inclusion of paramedicine in interdisciplinary palliative care and greater investment in both the generalist and specialist palliative paramedicine workforce.
Systematic video analysis of ACL injuries in professional Spanish male football (soccer): injury mechanisms, situational patterns, biomechanics and neurocognitive errors – a study on 115 consecutive cases
Authors: Buckthorpe Matthew , Pirli Capitani Luca , Olivares-Jabalera Jesus , Olmo Jesus , Della Villa Francesco 
Published: September 2024

ObjectiveA few video analysis studies have been published in recent years, but none specifically on Spanish football. We aimed to describe the mechanisms, situational patterns, biomechanics and neurocognitive errors related to anterior cruciate ligament (ACL) injuries in professional Spanish football matches.MethodsWe identified 167 consecutive ACL injuries across 12 seasons of the top two leagues in Spanish football. 115 (69%) injury videos were analysed for mechanism and situational pattern, while biomechanical analysis was possible in 81 cases. Neurocognitive errors were investigated for all non-contact injuries. Three independent reviewers evaluated each video. ACL injury epidemiology—month, timing within the match and pitch location at the time of injury was also documented.ResultsMore injuries occurred in defensive (n=68, 59%) than offensive (n=48, 41%) (p<0.01) playing situations. 16 (14%) injuries were direct contact, 49 (43%) indirect contact and 50 (43%) non-contact. Most injuries (89%) occurred during four main situational patterns: (1) pressing/tackling (n=47, 47%); (2) tackled (n=23, 23%); (3) landing from a jump (n=12, 12%) and regaining balance after kicking (n=6, 6%). Injuries generally involved a knee-dominant loading strategy in the sagittal plane with abducted hip and knee valgus. Of the non-contact injuries, 39 (78%) were deemed to involve a neurocognitive error. More (58%) injuries occurred in the first half of matches (p<0.01).ConclusionsACL injuries in Spanish football occurred similarly with non-contact and indirect contact mechanisms (44%). Four in five non-contact injuries involved a neurocognitive error. Most injuries occurred during four previously identified situational patterns, with more injuries earlier in the match.
Anti-metabolite chemotherapy increases LAG-3 expressing tumor-infiltrating lymphocytes which can be targeted by combination immune checkpoint blockade
Authors: Principe Nicola , Phung Amber-Lee , Stevens Kofi L P , Elaskalani Omar , Wylie Ben , Tilsed Caitlin M , Sheikh Fezaan , Orozco Morales M Lizeth , Kidman Joel , Marcq Elly , Fisher Scott A , Nowak Anna K , McDonnell Alison M , Lesterhuis W Joost , Chee Jonathan 
Published: September 2024

BackgroundAntibodies that target immune checkpoints such as cytotoxic T lymphocyte antigen 4 (CTLA-4), programmed cell death protein/ligand 1 (PD-1/PD-L1) are approved for treatment of multiple cancer types. Chemotherapy is often administered with immune checkpoint blockade (ICB) therapies that target CTLA-4 and/or PD-(L)1. ICB targeting other immune checkpoints such as lymphocyte activating gene-3 (LAG-3) has the potential to improve antitumor responses when combined with chemotherapy. Response to anti-PD-1 ICB is dependent on progenitor exhausted CD8+T cells (TPEX) in the tumor, but it is unclear how chemotherapy alters TPEXproportions and phenotype.MethodsHere we investigated whether sequential chemotherapy altered TPEXfrequency and immune checkpoint expression in multiple murine tumor models.ResultsTwo doses of two different anti-metabolite chemotherapies increased tumor infiltrating CD4+, and CD8+TPEXexpressing LAG-3 in multiple mouse models, which was not restricted to tumor antigen specific CD8+T cells. To determine if LAG-3+tumor infiltrating lymphocytes (TILs) could be targeted to improve tumor control, we administered anti-LAG-3 and anti-PD-1 ICB after two doses of chemotherapy and found combination therapy generated robust antitumor responses compared with each agent alone. Both anti-LAG-3 and anti-PD-1 ICB with chemotherapy were required for the complete tumor regression observed.ConclusionsChanges in immune checkpoint expression on TILs during chemotherapy administration informs selection of ICB therapies to combine with.
Inhibition of the NF-κB/HIF-1α signaling pathway in colorectal cancer by tyrosol: a gut microbiota-derived metabolite
Authors: Guo Jian , Meng Fanqi , Hu Ruixue , Chen Lei , Chang Jiang , Zhao Ke , Ren Honglin , Liu Zengshan , Hu Pan , Wang Guangyi , Tai Jiandong 
Published: September 2024

BackgroundThe development and progression of colorectal cancer (CRC) are influenced by the gut environment, much of which is modulated by microbial-derived metabolites. Although some research has been conducted on the gut microbiota, there have been limited empirical investigations on the role of the microbial-derived metabolites in CRC.MethodsIn this study, we used LC-MS and 16S rRNA sequencing to identify gut microbiome-associated fecal metabolites in patients with CRC and healthy controls. Moreover, we examined the effects ofFaecalibacterium prausnitziiand tyrosol on CRC by establishing orthotopic and subcutaneous tumor mouse models. Additionally, we conducted in vitro experiments to investigate the mechanism through which tyrosol inhibits tumor cell growth.ResultsOur study revealed changes in the gut microbiome and metabolome that are linked to CRC. We observed thatFaecalibacterium prausnitzii, a bacterium known for its multiple anti-CRC properties, is significantly more abundant in the intestines of healthy individuals than in those of individuals with CRC. In mouse tumor models, our study illustrated thatFaecalibacterium prausnitziihas the ability to inhibit tumor growth by reducing inflammatory responses and enhancing tumor immunity. Additionally, research investigating the relationship between CRC-associated features and microbe–metabolite interactions revealed a correlation betweenFaecalibacterium prausnitziiand tyrosol, both of which are less abundant in the intestines of tumor patients. Tyrosol demonstrated antitumor activity in vivo and specifically targeted CRC cells without affecting intestinal epithelial cells in cell experiments. Moreover, tyrosol treatment effectively reduced the levels of reactive oxygen species (ROS) and inflammatory cytokines in MC38 cells. Western blot analysis further revealed that tyrosol inhibited the activation of the NF-κB and HIF-1 signaling pathways.ConclusionsThis study investigated the relationship between CRC development and changes in the gut microbiota and microbial-derived metabolites. Specifically, the intestinal metabolite tyrosol exhibits antitumor effects by inhibiting HIF-1α/NF-κB signaling pathway activation, leading to a reduction in the levels of ROS and inflammatory factors. These findings indicate that manipulating the gut microbiota and its metabolites could be a promising approach for preventing and treating CRC and could provide insights for the development of anticancer drugs.
Angioplasty and/or stenting following successful mechanical thrombectomy for intracranial atherosclerosis-related emergent large vessel occlusive stroke (ASSET): protocol of a multicentre randomised trial
Authors: Liao Geng , Qiao Hongyu , Dai Chengbo , Yi Weiwen , Zhang Liang , Liang Zai , Li Li , He Yuemei , Zhang Zhenyu , Ji Zhong , Huang Li’an 
Published: September 2024

RationaleThe management of residual stenosis after mechanical thrombectomy in patients with intracranial atherosclerotic stenosis-related emerge large vessel occlusive (ICAS-LVO) stroke is still unclear question in clinical practice.AimTo demonstrate the design of a clinical trial on emergency balloon angioplasty and/or stenting (BAS) combined with standard medical treatment (SMT) for residual stenosis of ICAS-LVO stroke patients with successful recanalisation.DesignASSET is a multicentre, prospective, randomised, open-label, blinded end-point, controlled clinical trial designed (PROBE) by investigators. This trial evaluates the effectiveness and the safety of emergency BAS in combination with SMT compared with SMT alone in ICAS-LVO stroke patients with successful recanalisation (defined as expanded treatment in cerebral ischaemia grade of 2b50-3 and maintained for more than 20 min) and residual stenosis (defined as ≥50%) up to 24 hours after the onset of symptoms or the last known well.OutcomeThe primary outcome assessed at 90 (±7) days after randomisation is the incidence of ischaemic stroke in the responsible vessel. Symptomatic intracranial haemorrhage within 24 (±3) hours is the primary safety outcome.DiscussionThe ASSET trial is designed to provide strong evidence on the effectiveness and safety of emergency BAS to treat residual stenosis after successful recanalisation in patients with ICAS-LVO stroke.Trial registration numberChiCTR2300079069
Disordered Gut Microbiome and Alterations in Metabolic Patterns Are Associated With Hypertensive Left Ventricular Hypertrophy
Authors: Cao Rong , Gao Ting , Yue Jianwei , Sun Gang , Yang Xiaomin 
Published: September 2024

Background
Left ventricular hypertrophy (LVH) is most common when driven by hypertension, and it is a strong independent risk factor for adverse cardiovascular events and death. Some animal models support a role for gut microbiota and metabolites in the development of LVH, but cohort studies confirming these findings in populations are lacking.

Methods and Results

We investigated the alterations of gut microbiota and metabolites in 30 patients with hypertension, 30 patients with hypertensive LVH, and 30 matched controls on the basis of 16S rDNA and metabolomic analyses. Thirty stool and 90 serum samples were collected in fasting conditions. ANOVA/Kruskal–Wallis/Pearson's χ
2
/Fisher's exact test and Bonferroni's correction were used (
P
<0.0167) for comparison among the 3 groups. A regression analysis and subgroup analysis were performed between gut microbiota and left ventricular mass index (LVMI) and metabolites and LVMI, respectively. Spearman correlation analysis was performed between metabolites and flora and metabolites and LVMI. We observed LVH‐enriched
Faecalitalea
(β=6758.55 [95% CI, 2080.92–11436.18];
P
=0.009),
Turicibacter
(β=8424.76 [95% CI, 2494.05–14355.47];
P
=0.01),
Ruminococcus torques
group (β=840.88 [95% CI, 223.1–1458.67];
P
=0.013), and
Erysipelotrichaceae
UCG‐003 (β=856.37 [95% CI, 182.76–1529.98];
P
=0.019) were positively correlated with LVMI. A total of 1141 (in sera) and 2657 (in feces) metabolites were identified. There was a sex‐specific association between metabolites and LVMI. Significant changes in metabolic pathways in LVH were also observed, especially bile acid and lipid metabolism pathways.

Conclusions
Our study demonstrated the disordered gut microbiota and microbial metabolite profiles in LVH. This highlights the roles of gut bacteria and metabolite in this disease and could lead to new intervention, diagnostic, or management paradigms for LVH.

Registration

URL:
https://www.chictr.org.cn
; Unique Identifier: ChiCTR2200055603.
Project Lifeline–II: Feasibility of Implementing Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Allegheny County, Pennsylvania
Authors: Cloutier Renee M. , Dowd William N. , Aldridge Arnie , Walsh Caitlin A. , Messman Brett A. , Northcott Jessica L. , Talbert Abigail , Manolis Chronis , Campbell Vanessa , Pringle Janice L. 
Published: September 2024

Objectives: US community pharmacies are a unique and underused health service setting for identifying and potentially intervening with patients at risk of opioid overdose or opioid use disorder with evidence-based practices such as screening, brief intervention, and referral to treatment (SBIRT). The aim of our study was to assess the feasibility of implementing SBIRT in community pharmacies in an urban county in terms of engagement, reach, and equity across the cascade of pharmacy screening and care. Methods: Patients aged 18 years or older receiving a schedule II or III opioid prescription at 1 of 17 participating community pharmacies in Allegheny County, Pennsylvania, were invited to engage in SBIRT as part of Project Lifeline–II from June 2020 through January 2023. Participants completed a prescreen and/or a full screen. We calculated the percentage of patients who participated across the cascade of pharmacy screening and care, overall and by sex (male and female) and race (Black and White). Results: During the study period, 1952 unique adults (79.6%) were screened at least once (52.1% female; 58.0% White, 30.7% Black). Patients who identified as male (vs female) and Black (vs White) were more likely to have a positive prescreen (14.7% male vs 9.8% female; 16.4% Black vs 9.5% White), receive and complete a full screen (82.7% male vs 80.0% female; 83.6% Black vs 78.4% White), and score positively on the full screen (26.6% male vs 20.4% female; 26.8% Black vs 21.9% White). Conclusion: Although additional research is needed to characterize the full effect of Project Lifeline–II on patient outcomes, our findings help reinforce the benefits of multipronged public health initiatives that include community pharmacists to address the substance use disorder crisis in the United States.
Enhancing Nursing Care through Cultural Competence: Focus on the Inupiat Community
Authors: Brown Nicole , Billingsley Luanne , Brown Douglas D. , Agosta Lucie 
Published: September 2024

Introduction: This article explores the historical and cultural background of the Inupiat community, highlighting health disparities and emphasizing culturally competent care’s role in addressing them. Methods: Inupiat health beliefs, communication styles, family dynamics, and dietary habits are examined in relation to Western medical practices within tribal health systems. Strategies for cultural education include curriculum development, simulations, clinical assignments, and partnerships with Inupiat healthcare professionals. Results: Challenges in providing culturally competent care to the Inupiat community are identified, including barriers in nursing education and legal implications for nursing practice. Strategies for enhancing nursing cultural competency are outlined. Discussion: This paper advocates integrating cultural competency into nursing practices to improve care for the Inupiat community, focusing on training, education, and policy recommendations. It emphasizes the importance of respecting and integrating Inupiat cultural practices to enhance health outcomes and healthcare experiences.
Emotional Dysregulation in Emerging Adult ADHD: A Key Consideration in Explaining and Classifying Impairment and Co-Occurring Internalizing Problems
Authors: Goh Patrick K. , A. Wong Ashlyn W. W. , Suh Da Eun , Bodalski Elizabeth A. , Rother Yvette , Hartung Cynthia M. , Lefler Elizabeth K. 
Published: September 2024

Objective: The current study sought to clarify and harness the incremental validity of emotional dysregulation and unawareness (EDU) in emerging adulthood, beyond ADHD symptoms and with respect to concurrent classification of impairment and co-occurring problems, using machine learning techniques. Method: Participants were 1,539 college students ( Mage = 19.5, 69% female) with self-reported ADHD diagnoses from a multisite study who completed questionnaires assessing ADHD symptoms, EDU, and co-occurring problems. Results: Random forest analyses suggested EDU dimensions significantly improved model performance ( ps < .001) in classifying participants with impairment and internalizing problems versus those without, with the resulting ADHD + EDU classification model demonstrating acceptable to excellent performance (except in classification of Work Impairment) in a distinct sample. Variable importance analyses suggested inattention sum scores and the Limited Access to Emotional Regulation Strategies EDU dimension as the most important features for facilitating model classification. Conclusion: Results provided support for EDU as a key deficit in those with ADHD that, when present, helps explain ADHD’s co-occurrence with impairment and internalizing problems. Continued application of machine learning techniques may facilitate actuarial classification of ADHD-related outcomes while also incorporating multiple measures.
Gamified Practice Improves Paretic Arm Motor Behavior in Individuals With Stroke
Authors: Rubino Cristina , Lakhani Bimal , Larssen Beverley C. , Kraeutner Sarah N. , Andrushko Justin W. , Borich Michael R. , Boyd Lara A. 
Published: September 2024

Background Stroke is a heterogeneous condition, making choice of treatment, and determination of how to structure rehabilitation outcomes diﬃcult. Individualized goal-directed and repetitive physical practice is an important determinant of motor learning. Yet, many investigations of motor learning after stroke deliver task practice without consideration of individual capability of the learner. Objective We developed a gamified arm rehabilitation task for people with stroke that is personalized to individual capacity for paretic arm movement, provides a high dose of practice, progresses through increasingly difficulty levels that are dependent on the performance of the individual, and is practiced in an engaging environment. The objectives of the current study were to determine if 10 days of gamified, object intercept training using the paretic arm would improve arm movement speed and clinical outcome measures of impairment or function. Methods Individuals with chronic stroke and age-matched controls engaged in 10 days of gamified, skilled motor practice of a semi-immersive virtual reality-based intercept and release task. The paretic arm was assessed using the Fugl-Meyer Assessment (motor impairment) and Wolf Motor Function Test (motor function) before and after training. Results Both groups showed faster arm movement speed with practice; individuals with stroke demonstrated reduced paretic arm motor impairment and increased function after the intervention. Age and sex (for both groups), and time post-stroke were not related to changes in movement speed. Conclusions Findings indicate that gamified motor training positively affects paretic arm motor behavior in individuals with mild to severe chronic stroke.