bluuebunny/crossref_metadata_2025_split huggingface dataset:
Questionnaire survey on cervical cancer screening and HPV awareness among patients at a local cancer center in Japan
Authors: Nakamura Kazuto , Kigure Keiko , Nishimura Toshio , Yamashita Soichi 
Published: July 2024

Abstract
Background
The incidence of cervical intraepithelial neoplasia is increasing in Japan. Although human papillomavirus (HPV) vaccination and cancer screening are crucial in preventing cancer-related mortality, the cervical cancer screening rate in Japan was only approximately 43.6% in 2022. This study aimed to conduct an epidemiological analysis of cervical cancer by collecting data from individual patients.

Methods
A questionnaire survey was administered to patients who visited our hospital between January 2017 and July 2023 owing to abnormal cervical cytological findings or a cancer diagnosis. Patients answered questions regarding their history of cervical cancer screening as well as their knowledge of HPV and cervical cancer.

Results
During the study period, 471 patients participated in the survey, with 35 declining to participate. Patients with Stage 1b1–4b primarily sought medical attention due to self-reported symptoms (P < 0.001); however, they were less likely to have undergone cervical cancer screening (P < 0.001). Additionally, older patients were less likely to be aware of the association of HPV with cervical and other cancers. Notably, 28 of the 129 patients with stage 1b1–4b cancer underwent cervical cancer screening within 2 years. The tumor location within the endocervical canal emerged as a significant factor contributing to the difficulty for an accurate diagnosis of precancerous or cervical cancer during cervical screening. Furthermore, non- squamous cell carcinoma (SCC) histology was another possible factor.

Conclusions
Our findings suggest the need to widely disseminate information regarding the significance of cancer screening to increase cancer screening rates. Moreover, establishing strategies for improving the accuracy of detecting lesions during screening for non-SCC and endocervical canal tumors is crucial.
Nurse managers’ managerial innovation and it’s relation to proactivity behavior and locus of control among intensive care nurses
Authors: Elbus Loly Mohamed Shawky , Mostafa Mohamed Gamal , Mahmoud Fatma Zaghloul , shaban Mostafa , Mahmoud Seham Aly 
Published: July 2024

Abstract
Background
The nursing profession is undergoing rapid transformation, requiring innovation in management approaches and proactive behaviors among staff. Nurse Managers play a vital role through managerial innovation, but its impacts on intensive care nurses’ proactivity and locus of control remain underexplored.

Objectives
This study aimed to assess the levels of Nurse Managers’ managerial innovation and relate it to proactivity behaviors and locus of control orientations among intensive care nurses.

Methods
A cross-sectional correlational design was adopted, recruiting 242 intensive care nurses from Tanta University Hospital, Egypt. Participants completed standardized questionnaires measuring perceived managerial innovation, proactivity behavior, and locus of control.

Results
Nurse Managers demonstrated moderately high innovation across all dimensions, especially in continuous learning and development (mean = 4.65) and advanced technology use (mean = 4.56). Nurses exhibited sound proactivity levels, particularly in adaptability (mean = 4.40) and planning (mean = 4.35). The majority of nurses showed an internal locus of control (64.5%). Managerial innovation had significant positive correlations with nurses’ proactivity (r = 0.45, p < 0.001) and internal locus of control (r = 0.42, p < 0.001). Regression analysis revealed age, gender, experience, education, and ICU type as significant predictors of proactivity and locus of control.

Conclusion
Innovative nursing leadership positively influences staff’s proactivity levels and perceived control over their practice. This underscores the vital role of nurse managers in creating empowering environments in intensive care.
Health-economic evaluation of orthogeriatric co-management for patients with forearm or humerus fractures: an analysis of insurance claims data from Germany
Authors: Henken Espen , König Hans-Helmut , Becker Clemens , Büchele Gisela , Friess Thomas , Jaensch Andrea , Rapp Kilian , Rothenbacher Dietrich , Konnopka Claudia 
Published: July 2024

AbstractOrthogeriatric co-management (OGCM) describes a collaboration of orthopedic surgeons and geriatricians for the treatment of fragility fractures in geriatric patients. While its cost-effectiveness for hip fractures has been widely investigated, research focusing on fractures of the upper extremities is lacking. Thus, we conducted a health economic evaluation of treatment in OGCM hospitals for forearm and humerus fractures.In a retrospective cohort study with nationwide health insurance claims data, we selected the first inpatient stay due to a forearm or humerus fracture in 2014–2018 either treated in hospitals that were able to offer OGCM (OGCM group) or not (non-OGCM group) and applied a 1-year follow-up. We included 31,557 cases with forearm (63.1% OGCM group) and 39,093 cases with humerus fractures (63.9% OGCM group) and balanced relevant covariates using entropy balancing. We investigated costs in different health sectors, length of stay, and cost-effectiveness regarding total cost per life year or fracture-free life year gained.In both fracture cohorts, initial hospital stay, inpatient stay, and total costs were higher in OGCM than in non-OGCM hospitals. For neither cohort nor effectiveness outcome, the probability that treatment in OGCM hospitals was cost-effective exceeded 95% for a willingness-to-pay of up to €150,000.We did not find distinct benefits of treatment in OGCM hospitals. Assigning cases to study groups on hospital-level and using life years and fracture-free life years, which might not adequately reflect the manifold ways these fractures affect the patients’ health, as effectiveness outcomes, might have underestimated the effectiveness of treatment in OGCM hospitals.
Determination of the impacts of supplemental dietary curcumin on post-partum uterine involution using pulsed-wave doppler ultrasonography in Zaraibi goat
Authors: Madbouly Hager , El-Shahat K. H. , Abdelnaby Elshymaa A. , El-Sherbiny Hossam R. , Fathi Mohamed 
Published: July 2024

AbstractThis study aimed to evaluate the impacts of supplemental dietary curcumin on post-partum uterine involution using pulsed-wave Doppler ultrasonography in postpartum goats. Ten pluriparous Zaraibi goats were used and divided into two groups. Group 1 (n = 5; control) received only a base diet. Group 2 (n = 5; treated) received a base diet supplemented with curcumin (200 mg/kg diet) daily for 28 days, starting from day 1 postpartum (PP) till day 28 PP. Uterine morphometrical changes (uterine horn diameter; UHD and caruncle diameter; CD), uterine hemodynamics (resistance and pulsatility indices (RI and PI), systolic/ diastolic ratio (S/D), peak systolic velocity (PSV), end-diastolic velocity (EDV), blood flow volume (BFV), and blood flow rate (BFR)), and progesterone level were evaluated. Results revealed that the diameter of the uterine horn decreased rapidly from day 1 to day 10 PP (> 50%) but more steadily from day 14 to day 28 PP in both groups. After day 21 PP, there was nearly no reduction in UHD and CD in both groups. The treated group had lower values of the RI and PI (P < 0.05) than the control group. Regarding the BFR and BFV in the treated group, there was a significant increase (P < 0.05) on day 17 PP, then started to decrease till day 28 PP. While in the control group, there was a significant decrease (P < 0.05) in BFR and BFV from day 1 PP till day 28 PP. In conclusion, the incorporation of curcumin in the diet of PP Zaraibi goats improved reproductive performance via improvements in uterine morphometric changes as well as blood perfusion.
Preparation and in vivo and ex vivo studies of sirolimus nano-in-situ gel ophthalmic formulation
Authors: Liu Ye , Chen Xu , Chen Xinghao , Chen Jie , Zhang Han , Xu Haonan , Jin Lu , Wang Qiao , Tang Zhan 
Published: July 2024

AbstractSirolimus (SR) is a macrolide with antifungal and antitumor immunosuppressant properties, classified as a selective inhibitor of mammalian target of rapamycin (mTOR). In this study, an ionic in situ gel of SR (SR-SUS-ISG) was formulated using gellan gum, exhibiting stability regardless of temperature and pH variations, causing minimal irritation. Harnessing the physiological conditions of the eye, SR-SUS-ISG underwent gelation upon contact with ions, increasing drug viscosity and prolonging retention on the ocular surface. Concurrently, SR-SUS-ISG displayed favorable shear dilution properties, reducing viscosity at ambient temperature, enhancing fluidity, and facilitating convenient packaging and transport. Biocompatibility assessments on both human corneal epithelial cells and rabbit eyes demonstrated that SR-SUS-ISG could well be tolerated. Pharmacokinetic investigations in rabbit ocular aqueous humor revealed sustained release, improved corneal penetration, and enhanced bioavailability. Additionally, in a rat corneal alkali burn model, SR-SUS-ISG exhibited inhibitory effects on corneal neovascularization, associated with decreased levels of the inflammatory factors VEGF and MMPs. These findings suggested that SR-SUS-ISG held promise as an effective ocular drug delivery system.
Graphical Abstract
A pH-triggered N-oxide polyzwitterionic nano-drug loaded system for the anti-tumor immunity activation research
Authors: Zhao Yan , Bai Yuansong , Li Mei , Nie Xin , Meng Hao , Shosei Shimizu , Liu Linlin , Yang Qingbiao , Shen Meili , Li Yapeng 
Published: July 2024

AbstractTriple negative breast cancer (TNBC) has the characteristics of low immune cell infiltration, high expression of tumor programmed death ligand 1 (PD-L1), and abundant cancer stem cells. Systemic toxicity of traditional chemotherapy drugs due to poor drug selectivity, and chemotherapy failure due to tumor drug resistance and other problems, so it is particularly important to find new cancer treatment strategies for TNBC with limited treatment options. Both the anti-tumor natural drugs curcumin and ginsenoside Rg3 can exert anti-tumor effects by inducing immunogenic cell death (ICD) of tumor cells, reducing PD-L1 expression, and reducing cancer stem cells. However, they have the disadvantages of poor water solubility, low bioavailability, and weak anti-tumor effect of single agents. We used vinyl ether bonds to link curcumin (Cur) with N-O type zwitterionic polymers and at the same time encapsulated ginsenoside Rg3 to obtain hyperbranched zwitterionic drug-loaded micelles OPDEA-PGED-5HA@Cur@Rg3 (PPH@CR) with pH response. In vitro cell experiments and in vivo animal experiments have proved that PPH@CR could not only promote the maturation of dendritic cells (DCs) and increase the CD4+ T cells and CD8+ T cells by inducing ICD in tumor cells but also reduce the expression of PD-L1 in tumor tissues, and reduce cancer stem cells and showed better anti-tumor effects and good biological safety compared with free double drugs, which is a promising cancer treatment strategy.
Endogenous and exogeneous stimuli-triggered reactive oxygen species evoke long-lived carbon monoxide to fight against lung cancer
Authors: Fang Yujia , Yang Jianjun , Liang Xiayi , Wu Jing , Xie Mengqing , Zhang Kun , Su Chunxia 
Published: July 2024

AbstractReactive oxygen species (ROS)-associated anticancer approaches usually suffer from two limitations, i.e., insufficient ROS level and short ROS half-life. Nevertheless, no report has synchronously addressed both concerns yet. Herein, a multichannel actions-enabled nanotherapeutic platform using hollow manganese dioxide (H-MnO2) carriers to load chlorin e6 (Ce6) sonosensitizer and CO donor (e.g., Mn2(CO)10) has been constructed to maximumly elevate ROS level and trigger cascade catalysis to produce CO. Therein, intratumoral H2O2 and ultrasound as endogenous and exogeneous triggers stimulate H-MnO2 and Ce6 to produce •OH and 1O2, respectively. The further cascade reaction between ROS and Mn2(CO)10 proceeds to release CO, converting short-lived ROS into long-lived CO. Contributed by them, such a maximumly-elevated ROS accumulation and long-lived CO release successfully suppresses the progression, recurrence and metastasis of lung cancer with a prolonged survival rate. More significantly, proteomic and genomic investigations uncover that the CO-induced activation of AKT signaling pathway, NRF-2 phosphorylation and HMOX-1 overexpression induce mitochondrial dysfunction to boost anti-tumor consequences. Thus, this cascade catalysis strategy can behave as a general means to enrich ROS and trigger CO release against refractory cancers.
Graphic Abstract
Optimization of micelle-encapsulated extremely small sized iron oxide nanoparticles as a T1 contrast imaging agent: biodistribution and safety profile
Authors: Suh Minseok , Park Ji Yong , Ko Guen Bae , Kim Ji Yoon , Hwang Do Won , Rees Louis , Conway Gillian E , Doak Shareen H , Kang Hyelim , Lee Nohyun , Hyeon Taeghwan , Lee Yun-Sang , Lee Dong Soo 
Published: July 2024

Abstract
Background
Iron oxide nanoparticles (IONPs) have been cleared by the Food and Drug Administration (FDA) for various clinical applications, such as tumor-targeted imaging, hyperthermia therapy, drug delivery, and live-cell tracking. However, the application of IONPs as T1 contrast agents has been restricted due to their high r2 values and r2/r1 ratios, which limit their effectiveness in T1 contrast enhancement. Notably, IONPs with diameters smaller than 5 nm, referred to as extremely small-sized IONPs (ESIONs), have demonstrated potential in overcoming these limitations. To advance the clinical application of ESIONs as T1 contrast agents, we have refined a scale-up process for micelle encapsulation aimed at improving the hydrophilization of ESIONs, and have carried out comprehensive in vivo biodistribution and preclinical toxicity assessments.

Results
The optimization of the scale-up micelle-encapsulation process, specifically employing Tween60 at a concentration of 10% v/v, resulted in ESIONs that were uniformly hydrophilized, with an average size of 9.35 nm and a high purification yield. Stability tests showed that these ESIONs maintained consistent size over extended storage periods and dispersed effectively in blood and serum-mimicking environments. Relaxivity measurements indicated an r1 value of 3.43 mM− 1s− 1 and a favorable r2/r1 ratio of 5.36, suggesting their potential as T1 contrast agents. Biodistribution studies revealed that the ESIONs had extended circulation times in the bloodstream and were primarily cleared via the hepatobiliary route, with negligible renal excretion. We monitored blood clearance and organ distribution using positron emission tomography and magnetic resonance imaging (MRI). Additionally, MRI signal variations in a dose-dependent manner highlighted different behaviors at varying ESIONs concentrations, implying that optimal dosages might be specific to the intended imaging application. Preclinical safety evaluations indicated that ESIONs were tolerable in rats at doses up to 25 mg/kg.

Conclusions
This study effectively optimized a scale-up process for the micelle encapsulation of ESIONs, leading to the production of hydrophilic ESIONs at gram-scale levels. These optimized ESIONs showcased properties conducive to T1 contrast imaging, such as elevated r1 relaxivity and a reduced r2/r1 ratio. Biodistribution study underscored their prolonged bloodstream presence and efficient clearance through the liver and bile, without significant renal involvement. The preclinical toxicity tests affirmed the safety of the ESIONs, supporting their potential use as T1 contrast agent with versatile clinical application.
Strategies to prevent blood loss and reduce transfusion in emergency general surgery, WSES-AAST consensus paper
Authors: Coccolini Federico , Shander Aryeh , Ceresoli Marco , Moore Ernest , Tian Brian , Parini Dario , Sartelli Massimo , Sakakushev Boris , Doklestich Krstina , Abu-Zidan Fikri , Horer Tal , Shelat Vishal , Hardcastle Timothy , Bignami Elena , Kirkpatrick Andrew , Weber Dieter , Kryvoruchko Igor , Leppaniemi Ari , Tan Edward , Kessel Boris , Isik Arda , Cremonini Camilla , Forfori Francesco , Ghiadoni Lorenzo , Chiarugi Massimo , Ball Chad , Ottolino Pablo , Hecker Andreas , Mariani Diego , Melai Ettore , Malbrain Manu , Agostini Vanessa , Podda Mauro , Picetti Edoardo , Kluger Yoram , Rizoli Sandro , Litvin Andrey , Maier Ron , Beka Solomon Gurmu , De Simone Belinda , Bala Miklosh , Perez Aleix Martinez , Ordonez Carlos , Bodnaruk Zenon , Cui Yunfeng , Calatayud Augusto Perez , de Angelis Nicola , Amico Francesco , Pikoulis Emmanouil , Damaskos Dimitris , Coimbra Raul , Chirica Mircea , Biffl Walter L. , Catena Fausto 
Published: July 2024

AbstractEmergency general surgeons often provide care to severely ill patients requiring surgical interventions and intensive support. One of the primary drivers of morbidity and mortality is perioperative bleeding. In general, when addressing life threatening haemorrhage, blood transfusion can become an essential part of overall resuscitation. However, under all circumstances, indications for blood transfusion must be accurately evaluated. When patients decline blood transfusions, regardless of the reason, surgeons should aim to provide optimal care and respect and accommodate each patient’s values and target the best outcome possible given the patient’s desires and his/her clinical condition. The aim of this position paper was to perform a review of the existing literature and to provide comprehensive recommendations on organizational, surgical, anaesthetic, and haemostatic strategies that can be used to provide optimal peri-operative blood management, reduce, or avoid blood transfusions and ultimately improve patient outcomes.
Analysis of cardiac arrest after coronary artery bypass grafting
Authors: Yang Tengjiao , Tiemuerniyazi Xieraili , Hu Zhan , Feng Wei , Xu Fei 
Published: July 2024

Abstract
Background
Cardiac arrest after coronary artery bypass grafting (CABG) is a serious complication with low survival rate. The prognosis of patients with cardiac arrest in the general ward is worse than that in the intensive care unit (ICU) because of the delayed and poor rescue conditions.

Methods
This retrospective study included patients who experienced cardiac arrest after CABG surgery between January 2010 and December 2019 at the Fuwai Hospital. Differences in cardiac arrest between the ICU and the general ward were compared. The patients were divided into shockable and non-shockable rhythm groups, and the differences between the two groups were compared. Finally, we proposed a management protocol for cardiac arrest in the general ward.

Results
We retrospectively analyzed 41,450 patients who underwent CABG only, of whom 231 (0.56%) experienced cardiac arrest post-surgery in the ICU (185/231) or in the general ward (46/231). The rescue success rate and 30-day survival rate of the patients with cardiac arrest in the general ward were 76.1% (35/46) and 58.7% (27/46), respectively. The incidence of the different arrhythmia types of cardiac arrest in the general ward compared with that in the ICU was different (P = 0.010). The 30-day survival rate of the non-shockable rhythm group was 31.8% (7/22), which was worse than that of the shockable rhythm group (83.3% [20/24]; P = 0.001). Kaplan–Meier survival analysis showed that the prognosis of the non-shockable group was poor (P < 0.001).

Conclusions
The incidence of cardiac arrest after CABG was low. The prognosis of patients in the general ward was worse than that of those in the ICU. The proportion of non-shockable rhythm type cardiac arrest was higher in the general ward than in the ICU, and patients in this group had a worse early prognosis.
circPTP4A2 knockdown suppresses NSCLC progression via regulating proliferation and activating anti-tumor immunity
Authors: Wang Chun , Xu Bin , Tao Chengzhi , Lin Huan , Liu Dan , Zhang Haitao 
Published: July 2024

Abstract
Background
With a considerable variety of cancer subtypes, Non-small cell lung cancer (NSCLC) poses a substantial threat to public health, affecting a large number of individuals and resulting in a high mortality rate. Circular RNA (circRNA) has been applied in various diseases, including cancers. This study aims to investigate the clinial significance and functional role of circPTP4A2 in NSCLC.

Methods
The serum and tissue samples were collected for detecting circPTP4A2 expression in NSCLC using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Actinomycin D was used to treat NSCLC cells to detect circPTP4A2 stability. The CCK-8 and Transwell assays were utilized to assess the effects of circPTP4A2 in NSCLC cells. The ELISA assay and cytotoxicity analysis were used to detect the roles of circPTP4A2 in immune escape.

Results
The serum and tissue circPTP4A2 expression was upregulated in NSCLC. The high circPTP4A2 had a relatively high value in differentiating NSCLC patients from healthy individuals. The proliferation, invasion, and immune escape were repressed by circPTP4A2 knockdown.

Conclusions
High circPTP4A2 has the potential to be a diagnostic biomarker in NSCLC. Silencing of circPTP4A2 receded the progression of NSCLC and enhanced antitumor immunity, which might provide potential targets and new ideas for improving the diagnosis and effect of immunotherapy in NSCLC patients.
Deciphering the genetic landscape of enhanced poly-3-hydroxybutyrate production in Synechocystis sp. B12
Authors: Santin Anna , Collura Flavio , Singh Garima , Morlino Maria Silvia , Bizzotto Edoardo , Bellan Alessandra , Gupte Ameya Pankaj , Favaro Lorenzo , Campanaro Stefano , Treu Laura , Morosinotto Tomas 
Published: July 2024

Abstract
Background
Microbial biopolymers such as poly-3-hydroxybutyrate (PHB) are emerging as promising alternatives for sustainable production of biodegradable bioplastics. Their promise is heightened by the potential utilisation of photosynthetic organisms, thus exploiting sunlight and carbon dioxide as source of energy and carbon, respectively. The cyanobacterium Synechocystis sp. B12 is an attractive candidate for its superior ability to accumulate high amounts of PHB as well as for its high-light tolerance, which makes it extremely suitable for large-scale cultivation. Beyond its practical applications, B12 serves as an intriguing model for unravelling the molecular mechanisms behind PHB accumulation.

Results
Through a multifaceted approach, integrating physiological, genomic and transcriptomic analyses, this work identified genes involved in the upregulation of chlorophyll biosynthesis and phycobilisome degradation as the possible candidates providing Synechocystis sp. B12 an advantage in growth under high-light conditions. Gene expression differences in pentose phosphate pathway and acetyl-CoA metabolism were instead recognised as mainly responsible for the increased Synechocystis sp. B12 PHB production during nitrogen starvation. In both response to strong illumination and PHB accumulation, Synechocystis sp. B12 showed a metabolic modulation similar but more pronounced than the reference strain, yielding in better performances.

Conclusions
Our findings shed light on the molecular mechanisms of PHB biosynthesis, providing valuable insights for optimising the use of Synechocystis in economically viable and sustainable PHB production. In addition, this work supplies crucial knowledge about the metabolic processes involved in production and accumulation of these molecules, which can be seminal for the application to other microorganisms as well.