bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of early palliative care intervention in autologous bone marrow transplantation: feasibility of a multicentric study
Authors: Argüello-Marina María , Callejas-Charavía Marta , Merchán-Muñoz Beatriz , Gainza-Miranda Daniel , Rico-Zampetti Agustina , Pérez-Maganto Raquel , Ruiz-Ares Gustavo , García-Ramírez Patricia , de Miguel-Llorente Dunia , García-Suárez Julio 
Published: July 2024

Abstract
Introduction
This prospective multicentre study evaluates the impact of Palliative Care Unit (PCU) intervention (Experimental Group, EG), during autologous hematopoietic stem cell transplantation (AHSCT) on quality of life (QoL), symptom control and healthcare resource use compared to standard practice (Control Group, CG). We used validated scales on Days 0 (stem cell infusion), + 7 (bone marrow aplasia, acute symptoms) and + 21 (aplasia recovery).

Results
In 40 patients (20 EG/ 20 CG: 45%/25% female, median age 57.5/59), QoL differed significantly at Day + 7 (EG: median 0.50; CG: -63.00; p < 0.001) and Day + 21 (EG: -2.00; CG: -129.00; p < 0.001). On Day 0, mean FACT-BMT scores were CG/EG: 131/ 89.35, reflecting the pre-transplant intervention of the PCU in EG patients. For pain (EG median 0.00, CG median 2.50; p = 0.01), 45% EG patients used opioids on day 0 (mean 38.5 mg morphine/day/patient). Reduced pain control impacted nutritional support (parenteral nutrition 45% CG, 5% EG; p = 0.08). Hospitalisation duration was longer in CG (median 18.5; EG median 13.00; p < 0.001). Despite the short follow-up and small sample size, PCU and HD collaboration improves QoL and symptom management during acute AHSCT, evident through pain control, analgesia management, reduced parenteral nutrition need and shorter hospital stays.
Strategies to strengthen the resilience of primary health care in the COVID-19 pandemic: a scoping review
Authors: Mosadeghrad Ali Mohammad , Afshari Mahnaz , Isfahani Parvaneh , Ezzati Farahnaz , Abbasi Mahdi , Farahani Shahrzad Akhavan , Zahmatkesh Maryam , Eslambolchi Leila 
Published: July 2024

Abstract
Background
Primary Health Care (PHC) systems are pivotal in delivering essential health services during crises, as demonstrated during the COVID-19 pandemic. With varied global strategies to reinforce PHC systems, this scoping review consolidates these efforts, identifying and categorizing key resilience-building strategies.

Methods
Adopting Arksey and O'Malley's scoping review framework, this study synthesized literature across five databases and Google Scholar, encompassing studies up to December 31st, 2022. We focused on English and Persian studies that addressed interventions to strengthen PHC amidst COVID-19. Data were analyzed through thematic framework analysis employing MAXQDA 10 software.

Results
Our review encapsulated 167 studies from 48 countries, revealing 194 interventions to strengthen PHC resilience, categorized into governance and leadership, financing, workforce, infrastructures, information systems, and service delivery. Notable strategies included telemedicine, workforce training, psychological support, and enhanced health information systems. The diversity of the interventions reflects a robust global response, emphasizing the adaptability of strategies across different health systems.

Conclusions
The study underscored the need for well-resourced, managed, and adaptable PHC systems, capable of maintaining continuity in health services during emergencies. The identified interventions suggested a roadmap for integrating resilience into PHC, essential for global health security. This collective knowledge offered a strategic framework to enhance PHC systems' readiness for future health challenges, contributing to the overall sustainability and effectiveness of global health systems.
Acute radiation skin injury in stage III-IV head and neck cancer: scale correlates and predictive model
Authors: Zhou Zihan , Lin Junjian , Wang Ying , Chen Yunhao , Zhang Yang , Ding Xingchen , Xu Benhua 
Published: July 2024

Abstract
Purpose
Active radiation skin injury (ARSI) has the highest incidence of acute adverse reactions caused by radiotherapy (RT) in patients with head and neck cancer (HNC). This study aimed to screen risk factors that can facilitate the identification of HNC patients at high risk of ARSI.

Methods
Data from 255 stage III-IV HNC patients who underwent intensity-modulated radiation therapy (IMRT) were collected. The data from our medical records, including clinical characteristics and hematological indices before RT, were retrospectively collected and arranged. The Common Terminology Criteria for Adverse Events Criteria (CTCAE), Radiation Therapy Oncology Group Criteria (RTOG), World Health Organization Criteria (WHO), Oncology Nursing Society (ONS), Acute Radiation Dermatitis Graduation Scale, Douglas & Fowler and Radiation Dermatitis Severity Scale (RDSS) were used to assess ARSI. Of these, CTCAE was used for further analysis. Binary logistic regression analyses were used to identity risk factors. To establish the correction between each risk factor and the ARSI score, the odds ratio (OR) and 95% confidence interval (CI) were computed.

Results
The assessment results of the CTCAE with RTOG, WHO, ONS, Graduation Scale, Douglas & Fowler and RDSS have good consistency. After radiotherapy, 18.4% of patients had at least 3 (3 +) grade ARSI. Multivariate logistic regression analysis revealed that the KPS score, blood glucose level, white blood cell count, and plasma free thyroxine (FT4) concentration were independent risk factors for 3 + grade ARSI. A nomogram was constructed on the basis of these risk factors, which demonstrated good predictive power according to the area under the ROC curve (AUC). The satisfactory consistency and clinical efficacy of the nomogram were confirmed by calibration curves and decision curve analysis (DCA).

Conclusion
A low KPS score, high blood glucose level, high white blood cell count, and high thyroid hormone prior to radiotherapy for stage III-IV HNC are independent risk factors for grade 3 + RSI.
Aptamer-functionalized triptolide with release controllability as a promising targeted therapy against triple-negative breast cancer
Authors: Chen Yao , Yang Jirui , Wang Chuanqi , Wang Tianbao , Zeng Yingjie , Li Xiao , Zuo Yi , Chen Hongyu , Zhang Chaozheng , Cao Yuening , Sun Chen , Wang Maolin , Cao Xiujun , Ge Xian , Liu Yilan , Zhang Ge , Deng Yun , Peng Cheng , Lu Aiping , Lu Jun 
Published: July 2024

AbstractTargeted delivery and precise release of toxins is a prospective strategy for the treatment of triple-negative breast cancer (TNBC), yet the flexibility to incorporate both properties simultaneously remains tremendously challenging in the X-drug conjugate fields. As critical components in conjugates, linkers could flourish in achieving optimal functionalities. Here, we pioneered a pH-hypersensitive tumor-targeting aptamer AS1411-triptolide conjugate (AS-TP) to achieve smart release of the toxin and targeted therapy against TNBC. The multifunctional acetal ester linker in the AS-TP site-specifically blocked triptolide toxicity, quantitatively sustained aptamer targeting, and ensured the circulating stability. Furthermore, the aptamer modification endowed triptolide with favorable water solubility and bioavailability and facilitated endocytosis of conjugated triptolide by TNBC cells in a nucleolin-dependent manner. The integrated superiorities of AS-TP promoted the preferential intra-tumor triptolide accumulation in xenografted TNBC mice and triggered the in-situ triptolide release in the weakly acidic tumor microenvironment, manifesting striking anti-TNBC efficacy and virtually eliminated toxic effects beyond clinical drugs. This study illustrated the therapeutic potential of AS-TP against TNBC and proposed a promising concept for the development of nucleic acid-based targeted anticancer drugs.
Association between the triglyceride-glucose (TyG) index and stroke risk in Chinese normal-weight adults: a population-based study
Authors: Wu Man , Li Chaoyang , Yu Yiqing , Zeng Lijuan , Qiu Yufei , Liu Jiali , Yang Fen , Han Yangyang 
Published: July 2024

Abstract
Background
Identifying high-risk populations and promoting stroke prevention measures can be achieved through studies on stroke and its risk factors. As a new alternative indicator of insulin resistance (IR), the triglyceride glucose (TyG) index may potentially increase stroke risk. However, the evidence confirming this association is inadequate and inconsistent, possibly due to variations in stroke assessment criteria or characteristics of the study populations. This study aims to evaluate the association between the TyG index and stroke risk level among individuals with normal-weight.

Methods
A total of 30,895 participants aged ≥ 40 years with normal-weight were enrolled in this study. The TyG index was calculated as Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Normal-weight was described as a body mass index (BMI) of 18.5-<24.0 kg/m2. Stroke risk was assessed by the Stroke Risk Assessment Scale, developed by the China National Stroke Screening and Prevention Project. To evaluate the associations between the TyG index and stroke risk level, multivariate logistic regression models were employed.

Results
Results showed that when the TyG index was considered as a continuous variable, each one unit increase in the TyG index was associated with a significantly higher risk of stroke [Moderate-risk (OR, 2.15; 95% CI, 2.03–2.28; P<0.001); High-risk (OR, 3.83; 95% CI, 3.57–4.10; P<0.001)]. Compared with Q1 of the TyG index, Q4 was significantly associated with moderate stroke risk (OR, 2.73; 95% CI, 2.50–2.99; P<0.001) and high stroke risk (OR, 5.39; 95% CI, 4.83–6.01; P<0.001). The continuous TyG index was an important risk factor for high stroke risk in the metabolically obese, normal-weight (MONW) individuals (OR, 3.44;95% CI, 2.92–4.06; P < 0.001). In the MONW individuals, when Q1 was used as a reference, participants in Q4 (OR, 5.33; 95% CI, 4.19–6.78; P < 0.001) was significantly associated with high stroke risk. Subgroup analysis showed significant interaction in the age and sex subgroups in the overall population (Pinteraction <0.001).

Conclusion
The risk of stroke is increased with the TyG index among Chinese adults of normal weight; hence, the index may be an important indicator for identifying high-risk stroke populations among individuals with normal body weight.
Tree-growth synchrony index, an effective indicator of historical climatic extremes
Authors: Jia Hengfeng , Zheng Jiacheng , Yang Jing , Lyu Lixin , Dong Yuntao , Fang Ouya 
Published: July 2024

AbstractBackgroundTree rings play an important role in reconstructing past climate. Growth differences among individual trees due to microclimatic conditions and local disturbances are averaged in developing tree-ring chronologies. Here, we addressed the problem of averaging by investigating growth synchrony in individual trees. We used tree-ring data of 1046 juniper trees from 32 sites on the Tibetan Plateau and 538 pine trees from 20 sites in the subtropical region of eastern China and calculated the tree-growth synchrony index (TGS).ResultsOur results showed that both the TGS index and tree-ring index could be indicators of interannual variation of climatic factors. The TGS index identified 20% more climatic extremes than tree-ring index over the last 50 years that high synchrony indicates extreme climate forcing in controlling forest growth.ConclusionsThe TGS index can identify extreme climatic events effectively than tree-ring index. This study provides a novel perspective for climate reconstruction, especially in the realm of tree growth response to extreme climate. Our findings contribute to understanding of the spatiotemporal dynamics and the causes of historical climate extremes and provide guidance for protecting trees from climate extremes in the future.
Can exercise benefits be harnessed with drugs? A new way to combat neurodegenerative diseases by boosting neurogenesis
Authors: Zhao Renqing 
Published: July 2024

AbstractAdult hippocampal neurogenesis (AHN) is affected by multiple factors, such as enriched environment, exercise, ageing, and neurodegenerative disorders. Neurodegenerative disorders can impair AHN, leading to progressive neuronal loss and cognitive decline. Compelling evidence suggests that individuals engaged in regular exercise exhibit higher production of proteins that are essential for AHN and memory. Interestingly, specific molecules that mediate the effects of exercise have shown effectiveness in promoting AHN and cognition in different transgenic animal models. Despite these advancements, the precise mechanisms by which exercise mimetics induce AHN remain partially understood. Recently, some novel exercise molecules have been tested and the underlying mechanisms have been proposed, involving intercommunications between multiple organs such as muscle-brain crosstalk, liver-brain crosstalk, and gut-brain crosstalk. In this review, we will discuss the current evidence regarding the effects and potential mechanisms of exercise mimetics on AHN and cognition in various neurological disorders. Opportunities, challenges, and future directions in this research field are also discussed.
Impacts of three inspiratory muscle training programs on inspiratory muscles strength and endurance among intubated and mechanically ventilated patients with difficult weaning: a multicentre randomised controlled trial
Authors: Réginault Thomas , Martinez Alejos Roberto , Coueron Roxane , Burle Jean-françois , Boyer Alexandre , Frison Eric , Vargas Frédéric 
Published: July 2024

Abstract
Background
Inspiratory muscle training (IMT) is well-established as a safe option for combating inspiratory muscles weakness in the intensive care setting. It could improve inspiratory muscle strength and decrease weaning duration but a lack of knowledge on the optimal training regimen raise to inconsistent results. We made the hypothesis that an innovative mixed intensity program for both endurance and strength improvement could be more effective. We conducted a multicentre randomised controlled parallel trial comparing the impacts of three IMT protocols (low, high, and mixed intensity) on inspiratory muscle strength and endurance among difficult-to-wean patients.

Methods
Ninety-two patients were randomly assigned to three groups with different training programs, where each performed an IMT program twice daily, 7 days per week, from inclusion until successful extubation or 30 days. The primary outcome was maximal inspiratory pressure (MIP) increase. Secondary outcomes included peak pressure (Ppk) increase as an endurance marker, mechanical ventilation (MV) duration, ICU length of stay, weaning success defined by a 2-day ventilator-free after extubation, reintubation rate and safety.

Results
MIP increases were 10.8 ± 11.9 cmH2O, 4.5 ± 14.8 cmH2O, and 6.7 ± 14.5 cmH2O for the mixed intensity (MI), low intensity (LI), and high intensity (HI) groups, respectively. There was a non-statistically difference between the MI and LI groups (mean adjusted difference: 6.59, 97.5% CI [− 14.36; 1.18], p = 0.056); there was no difference between the MI and HI groups (mean adjusted difference: − 3.52, 97.5% CI [− 11.57; 4.53], p = 0.321). No significant differences in Ppk increase were observed among the three groups. Weaning success rate observed in MI, HI and LI group were 83.7% [95% CI 69.3; 93.2], 82.6% [95% CI 61.2; 95.0] and 73.9% [95% CI 51.6; 89.8], respectively. MV duration, ICU length of stay and reintubation rate had similar values. Over 629 IMT sessions, six adverse events including four spontaneously reversible bradycardia in LI group were possibly related to the study.

Conclusions
Among difficult-to-wean patients receiving invasive MV, no statistically difference was observed in strength and endurance progression across three different IMT programs. IMT appears to be feasible in usual cares, but some serious adverse events such as bradycardia could motivate further research on the specific impact on cardiac system.
Trial registration Clinicaltrials.gov identifier: NCT02855619. Registered 28 September 2014
Acoustic ambiguity reduction (AAR) method: an acoustic signal identification method for GNSS-A observation considering instrumental signal distortion
Authors: Yokota Yusuke , Ishikawa Tadashi , Nagae Koya , Watanabe Shun-ichi , Nakamura Yuto , Kouno Kenji , Yoshizumi Yuto 
Published: July 2024

AbstractSeafloor geodetic observation technology is a pivotal method for capturing plate boundary earthquakes and related phenomena. Currently, this task is performed by Global Navigation Satellite System-Acoustic ranging (GNSS-A), a technique that integrates GNSS observations with acoustic ranging. This method involves measuring the round-trip travel time of an acoustic signal between a surface platform and a preinstalled seafloor station, which is then converted into a distance for positioning. While the horizontal positioning accuracy can reach the centimeter level, the vertical accuracy tends to be loser. Recent research has revealed that equipment-dependent distortion of sound waves causes problems for accurate travel time identification, leading to a decrease in vertical component accuracy. In this paper, we conducted an analysis of distortion tendencies using water tank test data and quantitatively identified differences in distortion magnitude related to instruments, angle dependence, and directional dependence attributed to the sea surface platform. We proposed a new identification algorithm, Acoustic Ambiguity Reduction (AAR) method, using a catalog of distortions for each device, and improved the observational capabilities of the vertical component.
Graphical Abstract
Harnessing cellulose-binding protein domains for the development of functionalized cellulose materials
Authors: Li Shaowei , Liu Guodong 
Published: July 2024

AbstractCellulosic materials are attracting increasing research interest because of their abundance, biocompatibility, and biodegradability, making them suitable in multiple industrial and medical applications. Functionalization of cellulose is usually required to improve or expand its properties to meet the requirements of different applications. Cellulose-binding domains (CBDs) found in various proteins have been shown to be powerful tools in the functionalization of cellulose materials. In this review, we firstly introduce the structural characteristics of commonly used CBDs belonging to carbohydrate-binding module families 1, 2 and 3. Then, we summarize four main kinds of methodologies for employing CBDs to modify cellulosic materials (i.e., CBD only, genetic fusion, non-covalent linkage and covalent linkage). Via different approaches, CBDs have been used to improve the material properties of cellulose, immobilize enzymes for biocatalysis, and design various detection tools. To achieve industrial applications, researches for lowering the production cost of CBDs, improving their performance (e.g., stability), and expanding their application scenarios are still in need.
Graphical abstract
The incretin effect in type 2 diabetes in a Sub-Saharan African population
Authors: Nielsen Signe Tellerup , Kweka Belinda , Praygod George , Filteau Suzanne , Olsen Mette Frahm , Friis Henrik , Faurholt-Jepsen Daniel , Krogh-Madsen Rikke 
Published: July 2024

Abstract
Aim
Type 2 diabetes is increasing in Sub-Saharan Africa, but the pathophysiology in this population is poorly investigated. In Western populations, the incretin effect is reduced in type 2 diabetes, leading to lowered insulin secretion. The aim of this study was to investigate the incretin effect in a group of Sub-Saharan Africans with type 2 diabetes.

Methods
Twenty adults diagnosed with type 2 diabetes, based on either an oral glucose tolerance test (n = 10) or on glycated hemoglobin A1c (n = 10), and 10 non-diabetic controls were included in an interventional study in Tanzania. We investigated the incretin effect as the difference between the plasma insulin area under the curve during an oral glucose tolerance test and that obtained during an intravenous glucose infusion. Differences between diabetes groups were analyzed by Kruskal–Wallis one-way analysis of variance.

Results
The incretin effect did not differ between groups (p = 0.45), and there was no difference in plasma concentrations of the incretin hormones during the OGTT.

Conclusion
A reduced incretin effect appears not to contribute to hyperglycemia in type 2 diabetes in this Tanzanian population. More research is needed to explain the diabetes phenotype often seen in Sub-Saharan Africa.

Trial registration
Clinicaltrials.gov: NCT03106480, date of registration: 04/10/2017.
Translation, cross-cultural adaptation, and psychometric validation of the Malay version of the Assessment of Quality of Life—6 Dimensions (Malay-AQoL-6D) instrument among Malaysians living with chronic heart failure
Authors: Tan Yi Jing , Ong Siew Chin , Goh Sook Pin , Chen Gang , Yong Vee Sim , Khor Wei Wern , Kan Ying Min , Choong Yong Ying , Zameram Ainul Mardhiyyah , Tan Lin Yuing , Voo James Yau Hon , Lam Kar Kei , Yen Chia How , Wahab Mohamed Jahangir Abdul , Abdulla Zarina Banu 
Published: July 2024

Abstract
Background
This study aimed to translate and culturally adapt the Assessment of Quality of Life (AQoL)-6D into Malay (Malay-AQoL-6D), and assesses the instrument’s acceptability, reliability, and validity among Malaysians living with chronic heart failure (HF).

Methods
The translation and cross-cultural adaptation process adhered to international guidelines. The Malay-AQoL-6D underwent content and face validity assessments via expert review, and pretesting among healthy individuals and patients with chronic conditions. Subsequent psychometric validation utilised clinico-sociodemographic data and paired AQoL-6D and EQ-5D-5L data from a health-related quality-of-life (HRQoL) survey involving Malay-speaking patients with HF, which encompassed assessments of Malay-AQoL-6D acceptability, internal consistency and test-retest reliability, as well as its construct, concurrent, convergent and divergent, and known-group validity.

Results
The Malay-AQoL-6D was deemed acceptable among clinicians and local patients, achieving a 90.8% completion rate among 314 patients surveyed. The instrument demonstrated strong content validity (item-level content validity index [CVI]: 0.83–1.00, average CVI: 0.98), internal consistency (Cronbach’s alpha: 0.72–0.89; MacDonald’s omega: 0.82–0.90, excluding the Senses dimension), and test-retest reliability (average intraclass correlation coefficients: 0.79–0.95). Confirmatory factor analysis confirmed the instrument’s two-level, six-factor structure (Satorra-Bentler [SB]-scaled χ2(df: 164): 283.67, p-value < 0.001; root mean square error of approximation [RMSEA]: 0.051; comparative fix index [CFI]: 0.945, Tucker-Lewis index [TLI]: 0.937; standardised root mean-squared error [SRMR]: 0.058). The Malay-AQoL-6D’s concurrent validity was evident through its good agreement with EQ-5D-5L. Multiple hypothesis tests further affirmed its construct and known-group validity. The Malay-AQoL-6D’s psychometric properties remained consistent across different missing data techniques.

Conclusion
The findings suggest that Malay-AQoL-6D could be a culturally acceptable, reliable, and valid HRQoL measure for quantifying HRQoL among the local HF population. Future studies are necessary to further validate the instrument against other measures and confirm the instrument’s test-retest reliability and responsiveness, which are possible with the availability of the Malay-AQoL-6D.