bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public health events and economic growth in a neoclassical framework
Authors: Wang Yunhao , Liu Yixuan , Peng Zhihan , Shang Zhaoyang , Gao Wei 
Published: June 2024

AbstractPublic health events (PHEs) have emerged as significant threats to human life, health, and economic growth. PHEs, such as COVID-19, have prompted a reevaluation for enhanced regular prevention and control (RPC). In this study, we focus on the core concept of prevention and control intensity (PCI), and establish a neoclassical economic growth model from the long-term and macro perspective to balance life protection and economic growth. The model construct the mechanism of PCI on economic growth through population dynamics and capital accumulation under the backdrop of RPC for PHEs. We find the conditions for PCI when the economy achieves steady state, and provides an algorithm establishing the optimal strategy that maximises per capita disposable income based on the optimal PCI and consumption. Simulation result quantifies an inverted U-shaped relationship between PCI and capital per capita, output per capita and consumption per capita in the steady state. The model suggests that, given the PHEs of inducing potential unemployment shock, it is worthwhile to combine the implementation of moderate PCI with coordinated policies of income distribution.
The effectiveness of social media-based microlearning in improving knowledge, self-efficacy, and self-care behaviors among adult patients with type 2 diabetes: an educational intervention
Authors: Rahbar Samira , Zarifsanaiey Nahid , Mehrabi Manoosh 
Published: June 2024

Abstract
Background
The purpose of this study is to investigate the impact of social media-based microlearning (SMBM) on enhancing the knowledge, self-care, and self-efficacy behaviors of patients with type 2 diabetes (T2D) receiving care at a hospital-based diabetes clinic in Zahedan, Iran.

Methods
This intervention study was conducted from September 2021 to the end of 2022, with an intervention group (SMBM) and a control group (conventional-based training) consisting of patients with T2D. A total of 80 eligible patients were selected using a convenience sampling method and randomly assigned to either the intervention group (n = 40) or the control group (n = 40). The knowledge level, self-care, and self-efficacy of the samples were assessed before and two weeks after the educational intervention. Data analysis was conducted using SPSS version 24, and independent and paired T-tests were used for analysis.

Results
The results of the study revealed that after the intervention, the levels of knowledge, self-care, and self-efficacy in the intervention group were significantly higher than those in the control group (p-value < 0.001).

Conclusion
In conclusion, the SMBM appears to be an effective tool for improving self-efficacy, self-care, and knowledge among patients with type 2 diabetes.
The effect of counseling based on health promotion awareness on self-care needs and reproductive and sexual health literacy of newly married women: a randomized controlled clinical trial study
Authors: Kohansal Fereshteh , Nourizadeh Roghaiyeh , Jahdi Niloufar Sattarzadeh , Bafrani Mahdie Arab , Mehrabi Esmat 
Published: June 2024

Abstract
Background
Despite the importance of health literacy and the self-care skills in improving individual and social health and health costs reduction, scientific evidence indicates women’s poor awareness of self-care needs and low health literacy concerning reproductive and sexual health in most societies. The present study was conducted to specify the effect of health awareness promotion on self-care needs and reproductive and sexual health literacy of newly married women.

Methods
This randomized controlled clinical trial was conducted on 64 newly married women aged 15–45 in Tehran, Iran from August 2021 to the end of December 2021. The participants were randomly assigned into the intervention (n = 32) and control (n = 32) groups. The intervention group received four individual health awareness-promotion education sessions. The reproductive and sexual self-care needs, and sexual health literacy questionnaires, were completed before and 4-week after the intervention through interview. The data were analyzed using SPSS26 software. The independent t-tests and ANCOVA were used to comparison the mean scores and a significance level of P < 0.05 was considered.

Results
The results of this study indicated that after counseling, the average overall score of perceived reproductive and sexual self-care needs significantly decreased in the intervention group [Mean (standard deviation(SD)): 125.70 (24.70)] compared to the control group [Mean (SD): 87.1 (23.42)][P = 0.001]. Also, the mean score of sexual and reproductive health literacy significantly increased in the intervention group [Mean (SD): 125.50 (14.09)] compared to the control group [Mean (SD): 97.15 (14.90)] after intervention [P = 0.01].

Conclusions
The results indicated the positive effect of health promotion awareness educations on reproductive and sexual self-care needs and health literacy among newly married women. Therefore, health promotion interventions should be incorporated in health services provision programs for newly married women in comprehensive health centers to improve the health of women and families.

Trial registration
Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N7 Date of registration: 2021-09-21. URL: https://fa.irct.ir/trial/58597.
Healthcare providers’ perspectives on sustaining respectful maternity care appreciated by mothers in five hospitals of Rwanda
Authors: Muhayimana Alice , Kearns Irene 
Published: June 2024

Abstract
Background
Childbirth reserves respect, as emphasized by the World Health Organization in 2018, and the focus towards the need for positive, dignified delivery experiences has become an integral aspect of Respectful Maternity Care (RMC). It is a known fact that RMC is pivotal for favourable birth outcomes and contributes to the satisfaction of maternity care. The absence of RMC negatively affects women's and newborns’ rights. The study aimed to explore healthcare providers’ perspectives on sustaining RMC actions that mothers previously reported.

Methodology
This study was conducted in five hospitals in the Eastern province of Rwanda, involving 5 Focus Group Discussions (FGDs) with midwives and nurses. For interviews, we purposively selected 5-unit managers and five physicians. Additionally, 40 midwives and nurses were recruited for the FGDs. The research utilized the Dream phase of Appreciative Inquiry (AI) for interviews and Focus Groups. Data collection aimed to gain insights into Healthcare Providers’ perceptions of how RMC is provided and how to establish and sustain RMC in Rwandan health facilities. Nvivo 12 was employed for organizing codes and creating a codebook, and thematic analysis was applied.

Results
Four themes with sub-themes emerged. Namely, 1) Women-centered care, with Compassionate care, Privacy and confidentiality maintenance, Information provision and Liberty in decision making, Effective communication, Family involvement, Cleanliness, and Equality care. 2) Professionalism compliance with Motivated staff, Teamwork, Continuous development, Quality work provision, and Community trust. 3) RMC encounters 4) RMC sustenance.

Conclusion and recommendations
The continuous pursuit of high RMC standards in Rwanda involves improving childbirth experiences through utilizing existing resources, ongoing improvement, and sustaining achievements. Key recommended actions in this study for sustaining RMC encompass promoting women-centred care, enhancing healthcare provider attitudes, ensuring professionalism, building community trust, maintaining conducive health facility environments, and involving leadership.
Perceived efficacy of case analysis as an assessment method for clinical competencies in nursing education: a mixed methods study
Authors: Yazeedi Basma Mohammed Al , Shakman Lina Mohamed Wali , Sunderraj Sheeba Elizabeth John , Prabhakaran Harshita , Arulappan Judie , Roach Erna Judith , Al Hashmi Aysha , Al Azri Zeinab 
Published: June 2024

Abstract
Background
Case analysis is a dynamic and interactive teaching and learning strategy that improves critical thinking and problem-solving skills. However, there is limited evidence about its efficacy as an assessment strategy in nursing education.

Objectives
This study aimed to explore nursing students’ perceived efficacy of case analysis as an assessment method for clinical competencies in nursing education.

Methods
This study used a mixed methods design. Students filled out a 13-item study-advised questionnaire, and qualitative data from the four focus groups was collected. The setting of the study was the College of Nursing at Sultan Qaboos University, Oman. Descriptive and independent t-test analysis was used for the quantitative data, and the framework analysis method was used for the qualitative data.

Results
The descriptive analysis of 67 participants showed that the mean value of the perceived efficacy of case analysis as an assessment method was 3.20 (SD = 0.53), demonstrating an 80% agreement rate. Further analysis indicated that 78.5% of the students concurred with the acceptability of case analysis as an assessment method (mean = 3.14, SD = 0.58), and 80.3% assented its association with clinical competencies as reflected by knowledge and cognitive skills (m = 3.21, SD = 0.60). No significant difference in the perceived efficacy between students with lower and higher GPAs (t [61] = 0.05, p > 0.05) was identified Three qualitative findings were discerned: case analysis is a preferred assessment method for students when compared to MCQs, case analysis assesses students’ knowledge, and case analysis assesses students’ cognitive skills.

Conclusions
This study adds a potential for the case analysis to be acceptable and relevant to the clinical competencies when used as an assessment method. Future research is needed to validate the effectiveness of case analysis exams in other nursing clinical courses and examine their effects on academic and clinical performance.
Exploring the potential of genetic analysis in historical blood spots for patients with iodine-deficient goiter and thyroid carcinomas in Switzerland and Germany (1929–1989)
Authors: Schulte Janine , Hotz Gerhard , Szinnai Gabor , Christ Emanuel , Foderà Gaspare , Krüsi Karl , Nussberger Peter , Kron Sarah , Schulz Iris 
Published: June 2024

AbstractIodine deficiency-induced goiter continues to be a global public health concern, with varying manifestations based on geography, patient’s age, and sex. To gain insights into clinical occurrences, a retrospective study analyzed medical records from patients with iodine deficiency-induced goiter or thyroid cancer who underwent surgery at the Community Hospital in Riehen, Switzerland, between 1929 and 1989. Despite today’s adequate iodine supplementation, a significant risk for iodine-independent goiter remains in Switzerland, suggesting that genetic factors, among others, might be involved. Thus, a pilot study exploring the feasibility of genetic analysis of blood spots from these medical records was conducted to investigate and enhance the understanding of goiter development, potentially identify genetic variations, and explore the influence of dietary habits and other environmental stimuli on the disease.Blood prints from goiter patients’ enlarged organs were collected per decade from medical records. These prints had been made by pressing, drawing, or tracing (i.e., pressed and drawn) the removed organs onto paper sheets. DNA analysis revealed that its yields varied more between the prints than between years. A considerable proportion of the samples exhibited substantial DNA degradation unrelated to sample collection time and DNA mixtures of different contributors. Thus, each goiter imprint must be individually evaluated and cannot be used to predict the success rate of genetic analysis in general. Collecting a large sample or the entire blood ablation for genetic analysis is recommended to mitigate potential insufficient DNA quantities. Researchers should also consider degradation and external biological compounds’ impact on the genetic analysis of interest, with the dominant contributor anticipated to originate from the patient’s blood.
Enterovirus-A71 exploits RAB11 to recruit chaperones for virus morphogenesis
Authors: Ng Qing Yong , Mahendran Vikneswari , Lim Ze Qin , Tan Jasmine Hwee Yee , Wong Joel Jie Feng , Chu Justin Jang Hann , Chow Vincent T. K. , Sze Newman Siu Kwan , Alonso Sylvie 
Published: June 2024

Abstract
Background
Enterovirus 71 (EV-A71) causes Hand, Foot and Mouth Disease (HFMD) in children and has been associated with neurological complications. The molecular mechanisms involved in EV-A71 pathogenesis have remained elusive.

Methods
A siRNA screen in EV-A71 infected-motor neurons was performed targeting 112 genes involved in intracellular membrane trafficking, followed by validation of the top four hits using deconvoluted siRNA. Downstream approaches including viral entry by-pass, intracellular viral genome quantification by qPCR, Western blot analyses, and Luciferase reporter assays allowed determine the stage of the infection cycle the top candidate, RAB11A was involved in. Proximity ligation assay, co-immunoprecipitation and multiplex confocal imaging were employed to study interactions between viral components and RAB11A. Dominant negative and constitutively active RAB11A constructs were used to determine the importance of the protein’s GTPase activity during EV-A71 infection. Mass spectrometry and protein interaction analyses were employed for the identification of RAB11A’s host interacting partners during infection.

Results
Small GTPase RAB11A was identified as a novel pro-viral host factor during EV-A71 infection. RAB11A and RAB11B isoforms were interchangeably exploited by strains from major EV-A71 genogroups and by Coxsackievirus A16, another major causative agent of HFMD. We showed that RAB11A was not involved in viral entry, IRES-mediated protein translation, viral genome replication, and virus exit. RAB11A co-localized with replication organelles where it interacted with structural and non-structural viral components. Over-expression of dominant negative (S25N; GDP-bound) and constitutively active (Q70L; GTP-bound) RAB11A mutants had no effect on EV-A71 infection outcome, ruling out RAB11A’s involvement in intracellular trafficking of viral or host components. Instead, decreased ratio of intracellular mature viral particles to viral RNA copies and increased VP0:VP2 ratio in siRAB11-treated cells supported a role in provirion maturation hallmarked by VP0 cleavage into VP2 and VP4. Finally, chaperones, not trafficking and transporter proteins, were found to be RAB11A’s top interacting partners during EV-A71 infection. Among which, CCT8 subunit from the chaperone complex TRiC/CCT was further validated and shown to interact with viral structural proteins specifically, representing yet another novel pro-viral host factor during EV-A71 infection.

Conclusions
This study describes a novel, unconventional role for RAB11A during viral infection where it participates in the complex process of virus morphogenesis by recruiting essential chaperone proteins.
Pitavastatin sensitizes the EGFR-TKI associated resistance in lung cancer by inhibiting YAP/AKT/BAD-BCL-2 pathway
Authors: Liu Jie , Fu Jialei , Fu Ping , Liu Menghan , Liu Zining , Song Bao 
Published: June 2024

Abstract
Background
Despite effective strategies, resistance in EGFR mutated lung cancer remains a challenge. Metabolic reprogramming is one of the main mechanisms of tumor drug resistance. A class of drugs known as “statins” inhibit lipid cholesterol metabolism and are widely used in patients with cardiovascular diseases. Previous studies have also documented its ability to improve the therapeutic impact in lung cancer patients who receive EGFR-TKI therapy. Therefore, the effect of statins on targeted drug resistance to lung cancer remains to be investigated.

Methods
Prolonged exposure to gefitinib resulted in the emergence of a resistant lung cancer cell line (PC9GR) from the parental sensitive cell line (PC9), which exhibited a traditional EGFR mutation. The CCK-8 assay was employed to assess the impact of various concentrations of pitavastatin on cellular proliferation. RNA sequencing was conducted to detect differentially expressed genes and their correlated pathways. For the detection of protein expression, Western blot was performed. The antitumor activity of pitavastatin was evaluated in vivo via a xenograft mouse model.

Results
PC9 gefitinib resistant strains were induced by low-dose maintenance. Cell culture and animal-related studies validated that the application of pitavastatin inhibited the proliferation of lung cancer cells, promoted cell apoptosis, and restrained the acquired resistance to EGFR-TKIs. KEGG pathway analysis showed that the hippo/YAP signaling pathway was activated in PC9GR cells relative to PC9 cells, and the YAP expression was inhibited by pitavastatin administration. With YAP RNA interference, pAKT, pBAD and BCL-2 expression was decreased, while BAX expression as increased. Accordingly, YAP down-regulated significantly increased apoptosis and decreased the survival rate of gefitinib-resistant lung cancer cells. After pAKT was increased by SC79, apoptosis of YAP down-regulated cells induced by gefitinib was decreased, and the cell survival rate was increased. Mechanistically, these effects of pitavastatin are associated with the YAP pathway, thereby inhibiting the downstream AKT/BAD-BCL-2 signaling pathway.

Conclusion
Our study provides a molecular basis for the clinical application of the lipid-lowering drug pitavastatin enhances the susceptibility of lung cancer to EGFR-TKI drugs and alleviates drug resistance.
Photosynthetic bacteria-based whole-cell inorganic-biohybrid system for multimodal enhanced tumor radiotherapy
Authors: Hua Shiyuan , Zhao Jun , Li Lin , Liu Chaoyi , Zhou Lihui , Li Kun , Huang Quan , Zhou Min , Wang Kai 
Published: June 2024

AbstractThe whole-cell inorganic-biohybrid systems show special functions and wide potential in biomedical application owing to the exceptional interactions between microbes and inorganic materials. However, the hybrid systems are still in stage of proof of concept. Here, we report a whole-cell inorganic-biohybrid system composed of Spirulina platensis and gold nanoclusters (SP-Au), which can enhance the cancer radiotherapy through multiple pathways, including cascade photocatalysis. Such systems can first produce oxygen under light irradiation, then convert some of the oxygen to superoxide anion (•O2−), and further oxidize the glutathione (GSH) in tumor cells. With the combination of hypoxic regulation, •O2− production, GSH oxidation, and the radiotherapy sensitization of gold nanoclusters, the final radiation is effectively enhanced, which show the best antitumor efficacy than other groups in both 4T1 and A549 tumor models. Moreover, in vivo distribution experiments show that the SP-Au can accumulate in the tumor and be rapidly metabolized through biodegradation, further indicating its application potential as a new multiway enhanced radiotherapy sensitizer.
Melt-electrowriting-enabled anisotropic scaffolds loaded with valve interstitial cells for heart valve tissue Engineering
Authors: Xu Chao , Yang Kun , Xu Yin , Meng Xiangfu , Zhou Ying , Xu Yanping , Li Xueyao , Qiao Weihua , Shi Jiawei , Zhang Donghui , Wang Jianglin , Xu Weilin , Yang Hongjun , Luo Zhiqiang , Dong Nianguo 
Published: June 2024

AbstractTissue engineered heart valves (TEHVs) demonstrates the potential for tissue growth and remodel, offering particular benefit for pediatric patients. A significant challenge in designing functional TEHV lies in replicating the anisotropic mechanical properties of native valve leaflets. To establish a biomimetic TEHV model, we employed melt-electrowriting (MEW) technology to fabricate an anisotropic PCL scaffold. By integrating the anisotropic MEW-PCL scaffold with bioactive hydrogels (GelMA/ChsMA), we successfully crafted an elastic scaffold with tunable mechanical properties closely mirroring the structure and mechanical characteristics of natural heart valves. This scaffold not only supports the growth of valvular interstitial cells (VICs) within a 3D culture but also fosters the remodeling of extracellular matrix of VICs. The in vitro experiments demonstrated that the introduction of ChsMA improved the hemocompatibility and endothelialization of TEHV scaffold. The in vivo experiments revealed that, compared to their non-hydrogel counterparts, the PCL-GelMA/ChsMA scaffold, when implanted into SD rats, significantly suppressed immune reactions and calcification. In comparison with the PCL scaffold, the PCL-GelMA/ChsMA scaffold exhibited higher bioactivity and superior biocompatibility. The amalgamation of MEW technology and biomimetic design approaches provides a new paradigm for manufacturing scaffolds with highly controllable microstructures, biocompatibility, and anisotropic mechanical properties required for the fabrication of TEHVs.
Impact of early high protein intake in critically ill patients: a randomized controlled trial
Authors: Wang Yifei , Ye Yanyang , Xuan Lusha , Xu Lijie , Wang Pengpeng , Ma Jun , Wang Yuyan , Chen Yanjun , Miao Jinli , Wang Wenmin , Zhou Lingjie 
Published: June 2024

Abstract
Background
Conflicting findings regarding the impact of High protein intake during the early phase in critically ill patients have been reported. Therefore, we aimed to assess the influence of higher early protein intake on the prognosis of critically ill patients.

Methods
This randomized controlled trial involved 173 critically ill patients who stayed in the Intensive Care Unit/Emergency ICU (ICU/EICU) for at least 7 days. The Low group (n = 87) and High group (n = 86) received protein supplementation of 0.8 g/kg.d and 1.5 g/kg.d, respectively, within 1–3 days of enteral nutrition (EN) initiation, with both groups transitioning to 1.5 g/kg.d on the 4th day. The serum prealbumin (PA), blood urea nitrogen/creatinine, and rectus femoris muscle thickness and cross-sectional area of all patients was measured on the 1th, 3rd, 5th, 7th day, and the day of ICU/EICU discharge.

Results
Patients in both Low and High groups showed no significant differences in age, APACHE II scores, or other demographic and baseline characteristics. There were also no significant differences in the primary outcome (28-day mortality rate) and secondary outcomes (incidence rate of refeeding syndrome and EN tolerance score) between the two groups. However, the Low group exhibited a significantly higher 28-day mortality rate (HR = 2.462, 95% CI: 1.021–5.936, P = 0.045) compared to High group, as determined by Cox proportional hazards models incorporating the time factor. The High group exhibited significantly shorter durations of mechanical ventilation and ICU stay compared to the Low group. Serum PA levels were higher, and rectus femoris muscle atrophy rates were lower in the High group. Furthermore, for septic patients, high protein intake significantly reduced the 28-day mortality rate despite a small sample size (n = 34).

Conclusions
Our study indicates that increasing early protein intake to 1.5 g/kg.d may be safe and help improve the nutritional status and prognosis of critically ill patients.

Trial registration
This study was registered with the Chinese Clinical Trial Registry (ChiCTR2000039997, https://www.chictr.org.cn/).