bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring occupational therapy practice with children who are picky eaters and their families
Authors: Holland Luca C , Verdonck Michèle , Meredith Pamela J , Chilman Laine B 
Published: September 2024

Introduction: Picky eating is a complex phenomenon, impacting family routines and relationships. Occupational therapists often work with picky eaters and their families, yet little is understood about the occupational therapy process and reasoning in this context. This study was guided by the following research question: How do Australian occupational therapists choose and deliver interventions for children with picky eating and their families? Method: This qualitative interpretive descriptive study used in-depth semi-structured online interviews with 10 Australian-based occupational therapists working with children who are picky eaters. Data was analysed inductively following a thematic analysis process, and emergent themes were identified. Findings: Participants indicated that they used a complex reasoning process, with ‘Tailoring Occupational Therapy for Picky Eating’ emerging as the central finding. Key factors underpinning these tailored interventions were finding the why; addressing the why; and practising within context. Conclusion: To our knowledge, this is the first qualitative study to investigate occupational therapists’ reasoning processes when working with families impacted by picky eating. Occupational therapists described the complexity of picky eating, and the subsequent reasoning to find suitable interventions. Findings may guide occupational therapists’ clinical practice when working with children with picky eating and their families.
Association of Depression With Handgrip Strength and Muscle Mass in Young and Middle-Aged American Adults From NHANES 2011–2014: A Cross-Sectional Study
Authors: Jiang Zhenzhen , Jiang Shunlei , Ren Xia , Ji Xiaojie , Yu Hengheng , Zhao Zhiqiang 
Published: September 2024

Purpose To investigate relationship between depression and handgrip strength (HGS) and appendicular lean mass (ALM) in Young and middle-aged adults. Design Cross-sectional study. Setting Data from participants aged 20-59 from the 2011-2014 National Health and Nutrition Examination Survey. Sample In a study of 4927 middle-aged Americans, 2564 (52.30%) were men and 2363 (47.7%) were women, with an average age of 38.57 ± 11.72. Among this group, 716 individuals (14.53%) experienced mild depression, while 385 individuals (7.81%) suffered from moderate to severe depression. Measures Data of HGS and ALM were collected by handgrip test, and whole-body dual-energy X-ray absorptiometry scans. Depression was assessed using the Patient Health Questionnaire-9. Linear and logistic regression, restricted cubic spline regression analyses and subgroup analysis were conducted to evaluate the association. Results Following multivariate logistic regression analysis, the study showed that a 1-point increase in the depression score was associated with a 4% increase in the probability of reduced grip strength for both males (95% CI: 1.01-1.07) and females (95% CI: 1.01-1.06). Additionally, for males, there was a 5% increase in the likelihood of decreased muscle mass (95% CI: 1.01-1.09), whereas the decline in muscle mass for females did not exhibit statistical significance. Subgroup analysis indicated that the inverse relationship between depression and grip strength, along with the negative association between depression and muscle mass among males, remained consistent in the 40-59 age range. Conclusion This research revealed an inverse relationship between depression and grip strength in middle-aged and young individuals, and a negative association between depression and ALM was only noted in males. Early intervention could be beneficial from age 40.
Research Progress of γδT Cells in Tumor Immunotherapy
Authors: Li Yan , Mo Xin-pei , Yao Hong , Xiong Qiu-xia 
Published: September 2024

Background: γδT cells are special innate lymphoid cells, which are not restricted by major histocompatibility complex (MHC). γδT cells mainly exist in human epidermis and mucosal epithelium. They can secrete a variety of cytokines and chemokines involved in immune regulation, and produce effective cytotoxic responses to cancer cells. Purpose: To investigate the role of γδT cells in tumor immunotherapy, to understand its anti-tumor mechanism, and to explore the synergistic effect with other treatment modalities. This therapy is expected to become an important means of cancer treatment. Research Design: In this review presents a comprehensive analysis of the existing literature, focusing on the efficacy of γδT cells in a variety of tumor types. Results: The mechanism of γδT cells recognizing tumor antigens and killing tumor was clarified. The tumor immunotherapy based on γδT cells and its application in clinical practice were summarized. Conclusions: γδT cells have shown promising potential in tumor immunotherapy, but the therapeutic effect varies according to the type of tumor, and some patients have poor response. There are still some challenges in the treatment of this disease, such as non-standard expansion regimens and different responses of patients, indicating that the existing treatment methods are not complete. Future research should focus on perfecting γδT cell expansion protocols, gaining a deeper understanding of its anti-tumor mechanisms, and exploring synergies with other treatment modalities. This multifaceted study will promote the development of γδT cells in the field of cancer immunotherapy.
A Psychometric Evaluation of the Revised Version of the Adult ADHD Self-Report Scale in Chinese Adolescents
Authors: Xiao Ling-Rong , Zhao Gang , Zhang Pei , Tian Xian , Wu Xiao-Xue , Li Jun-Ru , Liu Si-Yan , Wu Hong-Mei 
Published: September 2024

Background: Adolescent-specific ADHD self-report screening measures can greatly increase the likelihood of correct diagnosis and timely treatment of ADHD in adolescents. This study provides preliminary evidence for evaluating the reliability and validity of the Adult ADHD Self-Report Scale-Revised (ASRS-R) in a school-based sample of Chinese adolescents. Methods: The ASRS-R and the Strengths and Difficulties Questionnaire (SDQ) were administered to 867 adolescents aged 12 to 16 years ( Mage = 13.08 years). Construct validity was assessed using correlation analysis of the ASRS-R with the SDQ. Moreover, confirmatory factor analysis (CFA), internal consistency, retest reliability, and measurement invariance of the scales were examined by gender. Results: CFA showed a two-dimensional factor structure of the ASRS-R, and the model fitted the data well (χ2/ df = 4.370, RMSEA = 0.062, TLI = 0.932, CFI = 0.940, GFI = 0.927, AGFI = 0.907, and SRMR = 0.038). The ASRS-R scale was invariant across gender and had satisfactory internal consistency (Cronbach’s alpha = .934) and test-retest reliability (intraclass correlation coefficient = .874). The construct validity, as calculated using the SDQ, was also acceptable. Conclusion: The ASRS-R can be a psychometrically reliable self-report instrument and provide preliminary support as a simple tool for identifying ADHD symptoms in Chinese adolescents. The findings provide evidence for extending the application of the ASRS, previously limited to adults, to the adolescent populations.
Use of the subcutaneous ureteral bypass device and urethral stenting for treatment of malignant urinary outflow tract obstructions in cats
Authors: Covo Mariel S , Berent Allyson C , Weisse Chick W 
Published: September 2024

Objectives The aim of this study was to describe the technical success and outcomes of ureteral and urethral decompression using the subcutaneous ureteral bypass (SUB) device and transurethral self-expanding metallic stents (SEMS) as a palliative treatment option for feline malignant urinary outflow tract obstructions. Methods A retrospective study was conducted of 14 cats with ureteral and/or urethral obstructions secondary to diagnosed or suspected transitional cell carcinoma (TCC). In all cats, a SUB device and/or a SEMS was placed to relieve the obstruction(s). Group 1 consisted of cats with ureteral obstructions, with or without concurrent urethral obstructions, and group 2 consisted of cats with only urethral obstructions. Results Eight cats were included in group 1 (seven with concurrent urethral obstructions) and six cats were included in group 2. TCC was confirmed in 8/14 cats. Repeat urethral obstruction due to tumor in growth occurred in 6/13 (46%) cats with a SEMS, and no cats developed recurrent ureteral obstructions after placement of the SUB device. Three cats had additional covered stents placed after urethral re-obstruction. The median survival time (MST) from the time of device placement was 52 days in group 1 (mean 92; range 14–349) and 80 days in group 2 (mean 96; range 7–209). The MST from the time of mass identification of the cats that did and did not receive adjunctive therapy was 349 days (mean 358; range 124–602) and 43 days (mean 113; range 14–423), respectively. Conclusions and relevance The use of bypass devices for feline malignant urinary outflow tract obstructions is a viable option to provide immediate renal and urinary bladder decompression. TCC in cats is locally aggressive and can result in urethral re-obstruction, prompting consideration for placing a covered urethral stent. The use of adjunctive therapies for malignant neoplasia should be considered to improve overall survival once the obstruction has been relieved.
Is occlusal contact re-established within 6 months after bonding of a fixed anterior bite plane in adolescents with a Class II division 2 incisor relationship? A randomised controlled trial
Authors: Dunbar Evelyn , Chalmers Elinor , Sivamurthy Gautham , Revie Gavin , McIntyre Grant T , Mossey Peter A 
Published: September 2024

Objective: To determine if re-establishment of occlusal contact was achieved within 6 months after insertion of a fixed anterior bite plane in individuals with Class II division 2 incisor relationship, and to evaluate the occlusal and vertical skeletal changes and acceptance of the intra-oral scanner and bite plane. Design: Single-centre two-arm parallel group randomised controlled trial with 1:1 allocation to intervention and control groups. Setting: Dundee Dental Hospital and Research School, UK. Participants: A total of 38 participants aged 9–16 years (11 males, 27 females) with Class II division 2 incisor relationship and increased overbite (greater than one-third incisor overlap). Methods: Participants were randomised to intervention (n = 19) and control (n = 19) groups using block randomisation. The intervention group had a fixed anterior bite plane, and the occlusion and vertical facial dimensions were monitored with intra-oral scans, lateral cephalograms and photographs. The control group received no treatment and occlusal and vertical facial dimensions were monitored with scans and photographs. Questionnaires were completed by participants and parents/carers. An intention-to-treat analysis was planned. Results: The overbite reduced in all participants in the intervention group (mean initial overbite: 5.07 mm, 95% confidence interval [CI] = 4.15–6.00; mean overbite after 6 months: 2.45 mm, 95% CI = 1.93–2.96). There was a mean incisor intrusion of 0.29 mm (95% CI = 0.17–0.42) and mean eruption of the first molars of 0.23 mm (95% CI = 0.09–0.37). There was no significant change in incisor inclination or vertical skeletal change. Feedback from participants and their parents/carers were generally positive. Conclusion: Fixed anterior bite planes effectively reduce an increased overbite in adolescents with a Class II division 2 incisor relationship, due to a combination of incisor intrusion and molar eruption with no change in incisor inclination or vertical skeletal change. Intra-oral scanning and fixed anterior bite planes are acceptable in adolescents.
Clinical Efficacy and Mechanistic Insights of Anshen Dingzhi Prescription on Breast Cancer-Related PTSD Through Network Pharmacology and Molecular Docking
Authors: Zhang Hao , Zhu Yongfu , Zhu Guoqi , Yang Shaojie 
Published: September 2024

Anshen Dingzhi prescription (ADP) is a classic prescription of traditional Chinese medicine, which has been used in the treatment of neuropsychiatric diseases. However, its treatment of breast cancer-related post-traumatic stress disorder (BC-PTSD) lacks clinical research evidence and its mechanism is not clear. The present study investigated the efficacy and action mechanism of ADP against BC-PTSD. The results of the clinical trial showed that after 4 weeks of treatment, both groups showed reduced post-traumatic stress disorder checklist-civilian version (PCL-C), Pittsburgh sleep quality index (PSQI), self-rating depression scale (SDS) and self-rating anxiety scale (SAS) scores, and increased functional assessment of cancer therapy-breast (FACT-B) scores. The serum cortisol (CORT), tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) levels were decreased and brain-derived neurotrophic factor (BDNF) level were increased, and the improvement of serum TNF-α, IL-1β, and BDNF in treatment group was better than that of the control group. The overall treatment efficacy in the treatment group (43.90%) was superior to that in the control group (23.81%), and the overall incidence of adverse effects was lower than that in the control group. The results of network analysis and molecular docking showed that ADP blood components could act on IL1B, TNF, and BDNF. ADP contributes to the treatment of BC-PTSD symptoms, with a mechanism possibly related to its regulatory effect on TNF-α, IL-1β, and BDNF levels. Trial registration: Chinese Clinical Trial Registry, http://www.chictr.org.cn,ChiCTR2300077801
Informal caregivers compared with users and health workers on well-being and respect for human rights in mental health care services
Authors: Atzeni Michela , Primavera Diego , Aviles Gonzales Cesar Ivan , Galletta Maura , Marchegiani Sonia , La Torre Giuseppe , Sancassiani Federica , Nonnis Marcello , Urban Antonio , Cantone Elisa , Romano Ferdinando , Nardi Antonio E , Carta Mauro G 
Published: September 2024

Background: This study aimed to measure differences among informal caregivers, users, and mental healthcare workers (MHW) regarding job/organizational satisfaction and perceptions of respect for rights in the mental health services of one region of Italy. Methods: A sample of 100 caregivers, 240 MHW, and 200 users completed the “Well-Being at Work and Respect for Human Rights Questionnaire” (WWRR) in community mental health centers in Sardinia. Results: Caregivers reported higher satisfaction toward MHW on perceiving respect for human rights among users (5.2 ± 1.0 vs 5.1 ± 1.1, p < 0.0001) and health professionals (5.3 ± 0.8 vs 4.5 ± 1.3, p < 0.0001) and organization well-being (5.1 ± 1.2 vs 3.9 ± 1.3, p < 0.0001); toward users about respect of rights of MHW (5.3 ± 0.8 vs 4.9 ± 1.2, p < 0.0001) and both toward users and MHW on dissatisfaction on resources ( p < 0.0001). Caregivers strongly highlighted insufficient resources for services. Conclusion: Despite caregiver satisfaction, resource deficiencies signal a critical juncture in Italian mental health care. Continued cuts in healthcare spending, especially in mental health, raise concerns for future outcomes.
Is the Diagnosis of fifth Metatarsal Fracture Type Consistent? An Interobserver Reliability Study
Authors: Chapman James , Gupta Shubhi , Choudhary Zain , Davies Thomas , Airey Grace , Mason Lyndon 
Published: September 2024

Background: Treatment pathways of fifth metatarsal fractures are commonly directed based on fracture classification, with particular proximal fractures typically requiring closer observation and possibly more aggressive management. Our aim is to investigate the interobserver reliability of assessment of subtypes of fifth metatarsal fractures. Methods: We included all patients referred to our virtual fracture clinic with a suspected or confirmed fifth metatarsal fracture. Plain anteroposterior radiographs were reviewed by 2 novice observers, initially trained on the fifth metatarsal classification identification. Eight different zones were defined based on anatomical location. Patients were excluded from analysis if neither observer could identify a fracture. An interobserver reliability analysis using Cohen κ coefficient was carried out, and degree of observer agreement described using Landis and Koch’s description. All data were analyzed using IBM SPSS, version 27. Results: A total of 1360 patients who met the inclusion criteria were identified. The 2 observers had moderate agreement when identifying fractures in all zones, apart from zone 1.2 and distal metaphysis (DM) fractures, which only achieved fair agreement (κ = 0.308 and 0.381 respectively). Zone 3 has slight agreement with zone 2 proximally, and there is an apparent difficulty with distal diaphyseal shaft (DS) fractures, resulting in a lot of crossover with DM, achieving a fair level of agreement (DS 312 vs 196; DM 120 vs 237; κ = .398, P < .001). Conclusion: Reliability of subcategorizing fifth metatarsal fractures using standardized instructions conveys moderate agreement in most cases. If the region of the fracture is going to be used in an algorithm to guide a management plan and clinical follow-up during a virtual clinic review, defining fractures of zones 1-3 needs careful consideration. Level of Evidence: Level III, retrospective cohort study.
Cytological analysis of flower development, insights into suitable growth area and genomic background: implications for Glehnia littoralis conservation and sustainable utilization
Authors: An Chang , Ye Kangzhuo , Jiang Runfa , Chen Jiayi , Yao Yixin , Lu Lin , Cheng Yan , Liu Ruoyu , Liu Xiaofen , Zhao Heming , Qin Yuan , Zheng Ping 
Published: September 2024

Abstract
Background
Glehnia littoralis F. Schmidt ex Miq., an endangered plant species with significant medicinal, edible, and ecological value, is now a central concern for conservation and sustainable utilization. Investigating the physiological and ecological mechanisms leading to its endangerment and elucidating its genetic background constitutes the foundation for conducting in-depth research on G. littoralis.

Results
Our observations have revealed a significant degree of floral sterility in wild populations of G. littoralis. The inflorescences of G. littoralis are classified into three types: completely fertile, completely sterile, and partially fertile compound umbels. Moreover, the flowers of G. littoralis can be categorized into fertile and sterile types. Sterile flowers exhibited abnormalities in the stigma, ovary, and ovules. This study is the first to discover that the presence or absence of a giant cell at the funiculus during the initiation of ovule primordium determines whether the flower can develop normally, providing cytological evidence for female sterility in G. littoralis. Conversely, both fertile and sterile flowers produced normally developed pollen. Field observations have suggested that robust plants bear more fertile umbels, while weaker ones have fewer or even no fertile umbels, indicating a close relationship between flower fertility and plant nutritional status. Our model correctly predicted that the eastern coastal regions of China, as well as prospective areas in Neimenggu and Sichuan, are suitable environments for its cultivation. Additionally, Using flow cytometry and genome survey, we estimated the genome size of G. littoralis to be 3.06 Gb and the heterozygosity to be 4.58%.

Conclusion
The observations and findings presented in this study were expected to provide valuable insights for further conserving its genetic resources and sustainable utilization of G. littoralis.
Sorafenib plus memory-like natural killer cell immunochemotherapy boosts treatment response in liver cancer
Authors: Eresen Aydin , Zhang Zigeng , Yu Guangbo , Hou Qiaoming , Chen Zhilin , Yu Zeyang , Yaghmai Vahid , Zhang Zhuoli 
Published: September 2024

Abstract
Background
Heterogeneity of hepatocellular carcinoma (HCC) presents significant challenges for therapeutic strategies and necessitates combinatorial treatment approaches to counteract suppressive behavior of tumor microenvironment and achieve improved outcomes. Here, we employed cytokines to induce memory-like behavior in natural killer (NK) cells, thereby enhancing their cytotoxicity against HCC. Additionally, we evaluated the potential benefits of combining sorafenib with this newly developed memory-like NK cell (pNK) immunochemotherapy in a preclinical model.

Methods
HCC tumors were grown in SD rats using subcapsular implantation. Interleukin 12/18 cytokines were supplemented to NK cells to enhance cytotoxicity through memory activation. Tumors were diagnosed using MRI, and animals were randomly assigned to control, pNK immunotherapy, sorafenib chemotherapy, or combination therapy groups. NK cells were delivered locally via the gastrointestinal tract, while sorafenib was administered systemically. Therapeutic responses were monitored with weekly multi-parametric MRI scans over three weeks. Afterward, tumor tissues were harvested for histopathological analysis. Structural and functional changes in tumors were evaluated by analyzing MRI and histopathology data using ANOVA and pairwise T-test analyses.

Results
The tumors were allowed to grow for six days post-cell implantation before treatment commenced. At baseline, tumor diameter averaged 5.27 mm without significant difference between groups (p = 0.16). Both sorafenib and combination therapy imposed greater burden on tumor dimensions compared to immunotherapy alone in the first week. By the second week of treatment, combination therapy had markedly expanded its therapeutic efficacy, resulting in the most significant tumor regression observed (6.05 ± 1.99 vs. 13.99 ± 8.01 mm). Histological analysis demonstrated significantly improved cell destruction in the tumor microenvironment associated with combination treatment (63.79%). Interestingly, we observed fewer viable tumor regions in the sorafenib group (38.9%) compared to the immunotherapy group (45.6%). Notably, there was a significantly higher presence of NK cells in the tumor microenvironment with combination therapy (34.79%) compared to other groups (ranging from 2.21 to 26.50%). Although the tumor sizes in the monotherapy groups were similar, histological analysis revealed a stronger response in pNK cell immunotherapy group compared to the sorafenib group.

Conclusions
Experimental results indicated that combination therapy significantly enhanced treatment response, resulting in substantial tumor growth reduction in alignment with histological analysis.