bluuebunny/crossref_metadata_2025_split huggingface dataset:
Has cross-level clinical coordination changed in the context of the pandemic? The case of the Catalan health system
Authors: Campaz-Landazabal Daniela , Vargas Ingrid , Sánchez Elvira , Cots Francesc , Plaja Pere , Perez-Castejón Joan Manuel , Sánchez-Hidalgo Antonio , Vázquez María Luisa 
Published: August 2024

Abstract
Background
The COVID-19 pandemic triggered numerous changes in health services organisation, whose effects on clinical coordination are unknown. The aim is to analyse changes in the experience and perception of cross-level clinical coordination and related factors of primary (PC) and secondary care (SC) doctors in the Catalan health system between 2017 and 2022.

Methods
Comparison of two cross-sectional studies based on online surveys by means of the self-administration of the COORDENA-CAT (2017) and COORDENA-TICs (2022) questionnaires to PC and SC doctors. Final sample n = 3308 in 2017 and n = 2277 in 2022. Outcome variables: experience of cross-level information and clinical management coordination and perception of cross-level clinical coordination in the healthcare area and related factors. Stratification variables: level of care and year. Adjusting variables: sex, years of experience, type of specialty, type of hospital, type of management of PC/SC. Descriptive bivariate and multivariate analysis using Poisson regressions models to detect changes between years in total and by levels of care.

Results
Compared with 2017, while cross-level clinical information coordination remained relatively high, with a slight improvement, doctors of both care levels reported a worse experience of cross-level clinical management coordination, particularly of care consistency (repetition of test) and accessibility to PC and, of general perception, which was worse in SC doctors. There was also a worsening in organisational (institutional support, set objectives, time available for coordination), attitudinal (job satisfaction) and interactional factors (knowledge between doctors). The use of ICT-based coordination mechanisms such as shared electronic medical records and electronic consultations between PC and SC increased, while the participation in virtual joint clinical conferences was limited.

Conclusions
Results show a slight improvement in clinical information but also less expected setbacks in some dimensions of clinical management coordination and in the perception of clinical coordination, suggesting that the increased use of some ICT-based coordination mechanisms did not counteract the effect of the worsened organisational, interactional, and attitudinal factors during the pandemic. Strategies are needed to facilitate direct communication, to improve conditions for the effective use of mechanisms and policies to protect healthcare professionals and services in order to better cope with new crises.
Beyond glycan barriers: non-cognate ligands and protein mimicry approaches to elicit broadly neutralizing antibodies for HIV-1
Authors: Walimbwa Stephen Ian , Maly Petr , Kafkova Leona Raskova , Raska Milan 
Published: August 2024

AbstractHuman immunodeficiency virus type 1 (HIV-1) vaccine immunogens capable of inducing broadly neutralizing antibodies (bNAbs) remain obscure. HIV-1 evades immune responses through enormous diversity and hides its conserved vulnerable epitopes on the envelope glycoprotein (Env) by displaying an extensive immunodominant glycan shield. In elite HIV-1 viremic controllers, glycan-dependent bNAbs targeting conserved Env epitopes have been isolated and are utilized as vaccine design templates. However, immunological tolerance mechanisms limit the development of these antibodies in the general population. The well characterized bNAbs monoclonal variants frequently exhibit extensive levels of somatic hypermutation, a long third heavy chain complementary determining region, or a short third light chain complementarity determining region, and some exhibit poly-reactivity to autoantigens. This review elaborates on the obstacles to engaging and manipulating the Env glycoprotein as an effective immunogen and describes an alternative reverse vaccinology approach to develop a novel category of bNAb-epitope-derived non-cognate immunogens for HIV-1 vaccine design.
Graphical Abstract
Reliability and validity of the German version of the Iowa infant feeding attitude scale (IIFAS-G) and relations to breastfeeding duration and feeding method
Authors: Suppiger Debora , Natalucci Giancarlo , Reinelt Tilman 
Published: August 2024

Abstract
Background
Public health initiatives (e.g., the Baby Friendly Hospital Initiative) have led to an increase in breastfeeding rates worldwide. However, as (exclusive) breastfeeding duration is still below WHO recommendations, it is crucial to understand the factors that influence decisions on breastfeeding practice. Modifiable psychological factors such as intention to breastfeed have therefore become targets of recent interventions. As the intention to breastfeed is among the strongest predictors of breastfeeding duration, reliable tools for measuring the intention to breastfeed are needed. The Iowa Infant Feeding Attitude Scale (IIFAS) measures attitudes towards infant feeding and is used in various languages and across different cultural contexts. However, there has been no German version of the IIFAS (IIFAS-G) so far. The aim of this study was to investigate reliability, validity, and associations of the IIFAS-G with feeding method and breastfeeding duration.

Methods
Between August and November 2022, a total of 353 mothers (Mage = 35 years, SDage = 4.2 years) of singleton infants (47.3% female (1 undetermined), Mage = 10.8 months, SDage = 4.7 months, age range: 3-547 days; 90.4% living in Switzerland) participated in an online survey. The IIFAS-G was administered as a part of a larger study on early child development and infant feeding method.

Results
The translated IIFAS-G showed unsatisfactory model fit for the two factor 17-item solution. Four items showed low factor loadings. After item reduction, a 13-item two factor solution showed satisfactory model fit (CFI = 0.92, TLI = 0.90, RMSEA = 0.07) and high internal consistency (Cronbach’s α = 0.85). The IIFAS-G score was higher for mothers who exclusively breastfed their infants compared to mothers who additionally or exclusively fed infant formula. Moreover, mothers with higher IIFAS-G scores were less likely to stop breastfeeding their child over the course of 1.5years (HR = 0.87).

Conclusion
A shorter two-factor IIFAS-G is proposed to investigate attitudes towards breastfeeding and formula feeding in German-speaking mothers.
Identification of circulating tumor cells captured by the FDA-cleared Parsortix® PC1 system from the peripheral blood of metastatic breast cancer patients using immunofluorescence and cytopathological evaluations
Authors: Ciccioli Mariacristina , Kim Kyukwang , Khazan Negar , Khoury Joseph D , Cooke Martin J , Miller M Craig , O’Shannessy Daniel J , Pailhes-Jimenez Anne-Sophie , Moore Richard G 
Published: August 2024

AbstractCirculating Tumor Cells (CTCs) may serve as a non-invasive source of tumor material to investigate an individual’s disease in real-time. The Parsortix® PC1 System, the first FDA-cleared medical device for the capture and harvest of CTCs from peripheral blood of metastatic breast cancer (MBC) patients for use in subsequent user-validated downstream analyses, enables the epitope-independent capture of CTCs with diverse phenotypes based on cell size and deformability. The aim of this study was to determine the proportion of MBC patients and self-declared female healthy volunteers (HVs) that had CTCs identified using immunofluorescence (IF) or Wright-Giemsa (WG) staining. Peripheral blood from 76 HVs and 76 MBC patients was processed on Parsortix® PC1 Systems. Harvested cells were cytospun onto a charged slide and immunofluorescently stained for identification of CTCs expressing epithelial markers. The IF slides were subsequently WG-stained and analyzed for CTC identification based on morphological features of malignant cells. All testing was performed by operators blinded to the clinical status of each subject. CTCs were identified on the IF slides in 45.3% (≥ 1) / 24.0% (≥ 5) of the MBC patients (range = 0 – 125, mean = 7) and in 6.9% (≥ 1) / 2.8% (≥ 5) of the HVs (range = 0 – 28, mean = 1). Among the MBC patients with ≥ 1 CTC, 70.6% had only CK + /EpCAM- CTCs, with none having EpCAM + /CK- CTCs. CTC clusters were identified in 56.0% of the CTC-positive patients. On the WG-stained slides, CTCs were identified in 42.9% (≥ 1) / 21.4% (≥ 5) of the MBC patients (range = 0 – 41, mean = 4) and 4.3% (≥ 1) / 2.9% (≥ 5) of the HVs (range = 0 – 14, mean = 0). This study demonstrated the ability of the Parsortix® PC1 System to capture and harvest CTCs from a significantly larger proportion of MBC patients compared to HVs when coupled with both IF and WG cytomorphological assessment. The presence of epithelial cells in subjects without diagnosed disease has been previously described, with their significance being unclear. Interestingly, a high proportion of the identified CTCs did not express EpCAM, highlighting the limitations of using EpCAM-based approaches.
Two-polarized roles of transcription factor FOSB in lung cancer progression and prognosis: dependent on p53 status
Authors: Zhang Hongchao , Zhang Guopei , Xiao Mingyang , Cui Su , Jin Cuihong , Yang Jinghua , Wu Shengwen , Lu Xiaobo 
Published: August 2024

Abstract
Background
Activator protein-1 (AP-1) represents a transcription factor family that has garnered growing attention for its extensive involvement in tumor biology. However, the roles of the AP-1 family in the evolution of lung cancer remain poorly characterized. FBJ Murine Osteosarcoma Viral Oncogene Homolog B (FOSB), a classic AP-1 family member, was previously reported to play bewilderingly two-polarized roles in non-small cell lung cancer (NSCLC) as an enigmatic double-edged sword, for which the reasons and significance warrant further elucidation.

Methods and Results
Based on the bioinformatics analysis of a large NSCLC cohort from the TCGA database, our current work found the well-known tumor suppressor gene TP53 served as a key code to decipher the two sides of FOSB – its expression indicated a positive prognosis in NSCLC patients harboring wild-type TP53 while a negative one in those harboring mutant TP53. By constructing a panel of syngeneically derived NSCLC cells expressing p53 in different statuses, the radically opposite prognostic effects of FOSB expression in NSCLC population were validated, with the TP53-R248Q mutation site emerging as particularly meaningful. Transcriptome sequencing showed that FOSB overexpression elicited diversifying transcriptomic landscapes across NSCLC cells with varying genetic backgrounds of TP53 and, combined with the validation by RT-qPCR, PREX1 (TP53-Null), IGFBP5 (TP53-WT), AKR1C3, and ALDH3A1 (TP53-R248Q) were respectively identified as p53-dependent transcriptional targets of FOSB. Subsequently, the heterogenous impacts of FOSB on the tumor biology in NSCLC cells via the above selective transcriptional targets were confirmed in vitro and in vivo. Mechanistic investigations revealed that wild-type or mutant p53 might guide FOSB to recognize and bind to distinct promoter sequences via protein-protein interactions to transcriptionally activate specific target genes, thereby creating disparate influences on the progression and prognosis in NSCLC.

Conclusions
FOSB expression holds promise as a novel prognostic biomarker for NSCLC in combination with a given genetic background of TP53, and the unique interactions between FOSB and p53 may serve as underlying intervention targets for NSCLC.
Optimization of a DiCre recombinase system with reduced leakage for conditional genome editing of Cryptosporidium
Authors: Huang Yue , Li Jinli , Pei Shifeng , You Heng , Liu Huimin , Guo Yaqiong , Xu Rui , Li Na , Feng Yaoyu , Xiao Lihua 
Published: August 2024

Abstract
Background
The dimerizable Cre recombinase system (DiCre) exhibits increased leaky activity in Cryptosporidium, leading to unintended gene editing in the absence of induction. Therefore, optimization of the current DiCre technique is necessary for functional studies of essential Cryptosporidium genes.

Methods
Based on the results of transcriptomic analysis of Cryptosporidium parvum stages, seven promoters with different transcriptional capabilities were screened to drive the expression of Cre fragments (FKBP-Cre59 and FRB-Cre60). Transient transfection was performed to assess the effect of promoter strength on leakage activity. In vitro and in vivo experiments were performed to evaluate the leaky activity and cleavage efficiency of the optimized DiCre system by polymerase chain reaction (PCR), nanoluciferase, and fluorescence analyses.

Results
The use of promoters with lower transcriptional activity, such as pcgd6_4110 and pcgd3_260, as opposed to strong promoters such as pActin, pα-Tubulin, and pEnolase, reduced the leakage rate of the system from 35–75% to nearly undetectable levels, as verified by transient transfection. Subsequent in vitro and in vivo experiments using stable lines further demonstrated that the optimized DiCre system had no detectable leaky activity. The system achieved 71% cleavage efficiency in vitro. In mice, a single dose of the inducer resulted in a 10% conditional gene knockout and fluorescent protein expression in oocysts. These fluorescently tagged transgenic oocysts could be enriched by flow sorting for further infection studies.

Conclusions
A DiCre conditional gene knockout system for Cryptosporidium with good cleavage efficiency and reduced leaky activity has been successfully established.

Graphical Abstract
Is environmental regulation conducive to the reduction of residents’ health costs? – evidence from the Chinese Family Panel Survey
Authors: Xu Zhihua , He Haibo , Qin Ying , Li Shuqin , Wang Chuwei , Li Mengjia 
Published: August 2024

Abstract
Background
In response to environmental degradation and the associated health challenges, the Chinese government has implemented a comprehensive array of environmental protection measures. Given the health enhancement objective of environmental protection measures and the considerable costs involved in the implementation process, evaluating whether environmental regulation is beneficial to reducing the health costs of the population is of great significance for enhancing environmental governance efficiency and social welfare. The data from the Chinese Family Panel Survey (CFPS) is applied to examine the effect of environmental regulation on the reduction of residents’ health costs from a microscopic perspective.

Results
The results indicate that for a 1% increase in total investment in environmental governance, residents’ health costs will decrease by 0.189%. The examination of the causal pathway suggests that implementing environmental regulation can diminish residents’ health costs through improving air quality and residents’ health status. Concurrently, there exist significant heterogeneities in the role of environmental regulation in reducing residents’ health costs. The effect of environmental regulation is more pronounced for the young, males, and individuals with better self-perceived health. Furthermore, the outcome of environmental regulation exhibits greater efficacy in urban areas compared to rural areas. Lastly, market-incentive environmental regulation in reducing health costs is more effective than command-controlled regulation.

Conclusions
Enhancing the intensity of environmental regulation contributes to decreasing residents’ health costs. The findings can provide policy reference for implementing environmental governance and achieving tangible enhancements in individuals' life quality.
Acute sleep deprivation-induced hepatotoxicity and dyslipidemia in middle-aged female rats and its amelioration by butanol extract of Tinospora cordifolia
Authors: Bajaj Payal , Kaur Tajpreet , Singh Amrit Pal , Kaur Gurcharan 
Published: August 2024

Abstract
Background
Sleep deprivation (SD) due to an unhealthy lifestyle poses an oxidative challenge and is closely associated with an increased risk and prevalence of different metabolic disorders. Although the negative consequences of SD are well reported on mental health little is known about its detrimental effects on liver function and lipid metabolism. Tinospora cordifolia is reported for its hepatoprotective activity in different pre-clinical model systems. The current study was designed to elucidate the cumulative effects of aging and acute SD on liver functions, oxidative stress, and lipid metabolism, and their management by butanol extract of T. cordifolia (B-TCE) using middle-aged female acyclic rats as the model system.

Results
Rats were divided into 4 groups: (1) Vehicle-undisturbed (VUD) (2) Vehicle-sleep deprived (VSD) (3) B-TCE pre-treated sleep-deprived (TSD) (4) B-TCE pre-treated undisturbed sleep (TUD). TSD and TUD groups were given 35 mg/kg of B-TCE once daily for 15 days followed by 12 h of sleep deprivation (6 a.m.–6 p.m.) of VSD and TSD group animals using the gentle-handling method while VUD and TUD group animals were left undisturbed. SD of VSD group animals increased oxidative stress, liver function disruption, and dyslipidemia which were ameliorated by B-TCE pre-treatment. Further, B-TCE was observed to target AMPK and its downstream lipid metabolism pathways as well as the p-Akt/cyclinD1/p-bad pathway of cell survival as possible underlying mechanisms of its hepatoprotective activity.

Conclusions
These findings suggest that B-TCE being a multi-component extract may be a potential agent in curtailing sleep-related problems and preventing SD-associated hepatotoxicity and dyslipidemia in postmenopausal women.

Graphical abstract
Graphical abstract to depict mechanism of action of B-TCE on liver function and lipid metabolism.
Cancer Survivors' Experience of Care and Financial Toxicity: Results From a National Survey
Authors: Halpern Michael T. , Thamm Carla , Knowles Reegan , Chan Raymond J. 
Published: August 2024

PURPOSE
Financial toxicity (FT) can adversely affect quality of life, treatment adherence, and clinical outcomes. Patient experience of care (PEC) captures patient's perspectives on interactions with health care providers (HCPs) and systems, but the impact of PEC on FT is unknown. This study examined the relationship between PEC and FT.

METHODS
We used data from the 2016-2017 Medical Expenditure Panel Survey (MEPS) Experience with Cancer Survivorship Supplement. PEC was assessed by patient-reported frequencies of their HCPs providing explanations that were easy to understand, listening carefully, showing respect, and spending enough time with the patient. FT was assessed by nine items to measure material, psychological, and behavioral FT. Analyses were performed using multivariable logistic regression controlling for sociodemographic and clinical characteristics and weighted to produce nationally representative estimates and account for survey nonresponse.

RESULTS

Data from 1,068 individuals diagnosed with cancer at age >18 years were assessed. A total of 30% reported material FT, 35% reported psychological FT, and 27% reported behavioral FT. Examining PEC, 64% of respondents indicated that HCPs always explained things, 60% always listened, 66% always showed respect, and 57% always spent adequate time with them. Odds of psychological FT were significantly (
P
< .05) lower among patients reporting HCPs always (
v
never/sometimes) listened to them (odds ratio [OR], 0.37 [95% CI, 0.19 to 0.70]), showed them respect (OR, 0.36 [95% CI, 0.16 to 0.81]), and spent enough time with them (OR, 0.47 [95% CI, 0.26 to 0.86]). Significant associations with PEC were also found with MEPS psychological FT items on worry about paying medical bills, family's financial stability, and keeping job/income because of cancer.

CONCLUSION
Worry/anxiety regarding costs can be a major factor affecting individuals diagnosed with cancer. Improving patient-provider interactions to enhance patient experience of care may reduce psychological financial toxicity.
A lightweight attention-based multi-frequency topology learning framework for driving fatigue detection
Authors: Lv DongMei , Dang WeiDong , Xia LiLi , Gao ZhongKe , Grebogi Celso 
Published: August 2024

Abstract
Driving fatigue has been one of the major causes of traffic accident. Efficient and accurate detection of driving fatigue are a legitimate public concern. In this paper, we conduct the simulated driving experiments and an EEG-based driving fatigue detection framework integrating multilayer brain network and convolutional neural network (CNN) is developed. This lightweight attention-based multi-frequency topology learning (AMFTL) framework first captures the fatigue-related multi-frequency brain topological information and then feeds it into a CNN-based topology feature extraction (TFE) module to fully explore and integrate the critical topological features. The quantitative analysis results show that there are significant differences in brain topologies between the alert and fatigue states. And experimental results show that our proposed framework achieves an average detection accuracy of 94.71% for driving fatigue, which outperforms the current state-of-the-art methods. This proposed framework is expected to open new venues for EEG-based brain state analysis, and holds promising practical application potential.
Postprandial Glucose Turnover Differs Between Adolescents and Adults With Type 1 Diabetes: Triple Tracer Mixed Meal Study
Authors: Romeres Davide , Ruchi F N U , Breton Marc D , Basu Ananda , DeBoer Mark D 
Published: August 2024

Abstract

Context
Insulin sensitivity (SI) varies with age in type 1 diabetes (T1D).

Objective
To compare postprandial glucose turnover and SI between adolescents and adults with T1D.

Design
This cross-sectional comparison at a clinical research unit included 21 early adolescents with T1D (T1D-adol) (12 F; age, 11.5 ± 0.5 years; BMI 19 ± 2 kg/m2), 13 adults with T1D (T1D-adult) (5 F; 37.8 ± 9.1 years; BMI 27 ± 2 kg/m2), and 14 anthropometrically matched adults without diabetes (ND) (7 F; 26.9 ± 7.0 years; BMI 25 ± 2.5 kg/m2). Using triple tracer mixed meal and oral glucose models, SI in T1D-adol and T1D-adult was compared.

Results
Postprandial glucose excursions were not different in T1D-adol vs T1D-adult (P = .111) but higher than in ND (P &lt; .01). Insulin excursions were also similar in T1D-adol vs T1D-adult (P = .600) and they were both lower (P &lt; .05) compared to ND, while glucagon excursions were lower (P &lt; .01) in T1D-adol than in T1D-adult and ND. Integrated rates of endogenous glucose production and glucose disappearance were lower in T1D-adol than in T1D-adult and in ND vs T1D-adult but did not differ between T1D-adol and ND. Meal glucose appearance did not differ between groups. While SI in T1D-adol vs ND was similar (P = .299), it was higher in T1D-adol and ND vs T1D-adult (P &lt; .01).

Conclusion
We report differences in parameters of postprandial glucose turnover and insulin sensitivity between adults and early adolescents with T1D that could, at least in part, be due to the shorter duration of diabetes among T1D-adol. These data support the concept that over time with T1D, endogenous glucose production increases and SI deteriorates.