bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caesarean section on maternal request: a qualitative study of conflicts related to shared decision-making and person-centred care in Sweden
Authors: Fredriksson Mio , Holmström Inger K , Höglund Anna T , Fleron Emma , Mattebo Magdalena 
Published: July 2024

Abstract
Background
Today, person-centred care is seen as a cornerstone of health policy and practice, but accommodating individual patient preferences can be challenging, for example involving caesarean section on maternal request (CSMR). The aim of this study was to explore Swedish health professionals’ perspectives on CSMR and analyse them with regard to potential conflicts that may arise from person-centred care, specifically in relation to shared decision-making.

Methods
A qualitative study using both inductive and deductive content analysis was conducted based on semi-structured interviews. It was based on a purposeful sampling of 12 health professionals: seven obstetricians, three midwives and two neonatologists working at different hospitals in southern and central Sweden. The interviews were recorded either in a telephone call or in a video conference call, and audio files were deleted after transcription.

Results
In the interviews, twelve types of expressions (sub-categories) of five types of conflicts (categories) between shared decision-making and CSMR emerged. Most health professionals agreed in principle that women have the right to decide over their own body, but did not believe this included the right to choose surgery without medical indications (patient autonomy). The health professionals also expressed that they had to consider not only the woman’s current preferences and health but also her future health, which could be negatively impacted by a CSMR (treatment quality and patient safety). Furthermore, the health professionals did not consider costs in the individual decision, but thought CSMR might lead to crowding-out effects (avoiding treatments that harm others). Although the health professionals emphasised that every CSMR request was addressed individually, they referred to different strategies for avoiding arbitrariness (equality and non-discrimination). Lastly, they described that CSMR entailed a multifaceted decision being individual yet collective, and the use of birth contracts in order to increase a woman’s sense of security (an uncomplicated decision-making process).

Conclusions
The complex landscape for handling CSMR in Sweden, arising from a restrictive approach centred on collective and standardised solutions alongside a simultaneous shift towards person-centred care and individual decision-making, was evident in the health professionals’ reasoning. Although most health professionals emphasised that the mode of delivery is ultimately a professional decision, they still strived towards shared decision-making through information and support. Given the different views on CSMR, it is of utmost importance for healthcare professionals and women to reach a consensus on how to address this issue and to discuss what patient autonomy and shared decision-making mean in this specific context.
Food insecurity, income loss, healthcare access, and other exacerbated social inequalities among people experiencing homelessness during the COVID-19 pandemic in Brazil (2021–2023)
Authors: Moura Heriederson Sávio Dias , Canatto Mayla Cristina Dinardi , Berra Thaís Zamboni , Silva Ruan Víctor dos Santos , Rosa Rander Junior , Campos Mônica Chiodi Toscano de , Costa Fernanda Bruzadelli Paulino da , Ribeiro Natacha Martins , Teibo Titilade Kehinde Ayandeyi , Araújo Juliana Soares Tenório de , Tártaro Ariela Fehr , Alves Yan Mathias , Souza Rosa Maria Pinheiro , Uchoa Severina Alice da Costa , Ferezin Letícia Perticarrara , Arcêncio Ricardo Alexandre 
Published: July 2024

Abstract
Background
During COVID-19, the number of people experiencing homelessness increased, further exacerbating the violation of basic rights necessary for human survival. Thus, the study aimed to investigate the inequalities associated with income loss and food insecurity among people experiencing homelessness during the COVID-19 pandemic in Brazil.

Methods
A cross-sectional study was conducted in 24 Brazilian state capitals and the Federal District among the homeless population using a validated instrument. Descriptive analyses and binary logistic regressions were performed.

Results
Among 1512 homeless participants (median age:37, range:18–89), 39.4% had incomplete primary education, 83.7% earned below minimum wage or had no income, 56.5% received government aid, and 87.1% used the Sistema Único de Saúde (Brazilian Public Health System-SUS). During the pandemic, 42.0% faced food difficulties, and 26.3% experienced income loss. Across Brazilian macroregions, lack of employment affected four regions, with high SUS dependency and food scarcity. In the North (72.7%) and Northeast (51.9%), most lacked government aid, while in the Midwest (51.6%), temporary income loss prevailed. In regression analyses, men, black/mixed race, those married or in a stable union, government aid recipients, and SUS users had greater difficulty acquiring food during COVID-19. Men with incomplete high school or higher education and income above minimum wage were less likely to suffer temporary income loss, and black/mixed race individuals and those living on the streets were more likely.

Conclusions
The study showed how socioeconomic factors increased income loss and food acquisition difficulties during COVID-19, exacerbating vulnerability and social inequities for the people experiencing homelessness.
Re-Purposing the Ordering of Routine Laboratory Tests in Hospitalized Medical Patients (RePORT): protocol for a multicenter stepped-wedge cluster randomised trial to evaluate the impact of a multicomponent intervention bundle to reduce laboratory test over-utilization
Authors: Ambasta Anshula , Holroyd-Leduc Jayna M. , Pokharel Surakshya , Mathura Pamela , Shih Andrew Wei-Yeh , Stelfox Henry T. , Ma Irene , Harrison Mark , Manns Braden , Faris Peter , Williamson Tyler , Shukalek Caley , Santana Maria , Omodon Onyebuchi , McCaughey Deirdre , Kassam Narmin , Naugler Chris 
Published: July 2024

Abstract
Background
Laboratory test overuse in hospitals is a form of healthcare waste that also harms patients. Developing and evaluating interventions to reduce this form of healthcare waste is critical. We detail the protocol for our study which aims to implement and evaluate the impact of an evidence-based, multicomponent intervention bundle on repetitive use of routine laboratory testing in hospitalized medical patients across adult hospitals in the province of British Columbia, Canada.

Methods
We have designed a stepped-wedge cluster randomized trial to assess the impact of a multicomponent intervention bundle across 16 hospitals in the province of British Columbia in Canada. We will use the Knowledge to Action cycle to guide implementation and the RE-AIM framework to guide evaluation of the intervention bundle. The primary outcome will be the number of routine laboratory tests ordered per patient-day in the intervention versus control periods. Secondary outcome measures will assess implementation fidelity, number of all common laboratory tests used, impact on healthcare costs, and safety outcomes. The study will include patients admitted to adult medical wards (internal medicine or family medicine) and healthcare providers working in these wards within the participating hospitals. After a baseline period of 24 weeks, we will conduct a 16-week pilot at one hospital site. A new cluster (containing approximately 2–3 hospitals) will receive the intervention every 12 weeks. We will evaluate the sustainability of implementation at 24 weeks post implementation of the final cluster. Using intention to treat, we will use generalized linear mixed models for analysis to evaluate the impact of the intervention on outcomes.

Discussion
The study builds upon a multicomponent intervention bundle that has previously demonstrated effectiveness. The elements of the intervention bundle are easily adaptable to other settings, facilitating future adoption in wider contexts. The study outputs are expected to have a positive impact as they will reduce usage of repetitive laboratory tests and provide empirically supported measures and tools for accomplishing this work.

Trial Registration
This study was prospectively registered on April 8, 2024, via ClinicalTrials.gov Protocols Registration and Results System (NCT06359587). https://classic.clinicaltrials.gov/ct2/show/NCT06359587?term=NCT06359587&recrs=ab&draw=2&rank=1
Transcriptomic response of prostate cancer cells to carbon ion and photon irradiation with focus on androgen receptor and TP53 signaling
Authors: Hänze Jörg , Mengen Lilly M. , Mernberger Marco , Tiwari Dinesh Kumar , Plagge Thomas , Nist Andrea , Subtil Florentine S. B. , Theiss Ulrike , Eberle Fabian , Roth Katrin , Lauth Matthias , Hofmann Rainer , Engenhart-Cabillic Rita , Stiewe Thorsten , Hegele Axel 
Published: July 2024

Abstract
Background
Radiotherapy is essential in the treatment of prostate cancer. An alternative to conventional photon radiotherapy is the application of carbon ions, which provide a superior intratumoral dose distribution and less induced damage to adjacent healthy tissue. A common characteristic of prostate cancer cells is their dependence on androgens which is exploited therapeutically by androgen deprivation therapy in the advanced prostate cancer stage. Here, we aimed to analyze the transcriptomic response of prostate cancer cells to irradiation by photons in comparison to carbon ions, focusing on DNA damage, DNA repair and androgen receptor signaling.

Methods
Prostate cancer cell lines LNCaP (functional TP53 and androgen receptor signaling) and DU145 (dysfunctional TP53 and androgen receptor signaling) were irradiated by photons or carbon ions and the subsequent DNA damage was assessed by immuno-cytofluorescence. Furthermore, the cells were treated with an androgen-receptor agonist. The effects of irradiation and androgen treatment on the gene regulation and the transcriptome were investigated by RT-qPCR and RNA sequencing, followed by bioinformatic analysis.

Results
Following photon or carbon ion irradiation, both LNCaP and DU145 cells showed a dose-dependent amount of visible DNA damage that decreased over time, indicating occurring DNA repair. In terms of gene regulation, mRNAs involved in the TP53-dependent DNA damage response were significantly upregulated by photons and carbon ions in LNCaP but not in DU145 cells, which generally showed low levels of gene regulation after irradiation. Both LNCaP and DU145 cells responded to photons and carbon ions by downregulation of genes involved in DNA repair and cell cycle, partially resembling the transcriptome response to the applied androgen receptor agonist. Neither photons nor carbon ions significantly affected canonical androgen receptor-dependent gene regulation. Furthermore, certain genes that were specifically regulated by either photon or carbon ion irradiation were identified.

Conclusion
Photon and carbon ion irradiation showed a significant congruence in terms of induced signaling pathways and transcriptomic responses. These responses were strongly impacted by the TP53 status. Nevertheless, irradiation mode-dependent distinct gene regulations with undefined implication for radiotherapy outcome were revealed. Androgen receptor signaling and irradiations shared regulation of certain genes with respect to DNA-repair and cell-cycle.
Examining the performance of responding to the Khoy earthquake 2022, challenges, strengths, and lessons learned: thematic analysis
Authors: Nazari Saeed , Kolivand Pirhossein , Zamani Elham , Karimi Kivi Hamid , Norouzi Razieh 
Published: July 2024

Abstract
Objective
Disasters in developing countries result in higher human and financial losses compared to global standards, with the death rate being 12 times higher than that of developed countries. Many experts attribute the failures in disaster management to the lack of a system for documenting and analyzing disaster management functions and not leveraging the experiences and lessons learned. This study employed a qualitative data collection approach, utilizing semi-structured interviews with managers, deputies, members of operational teams, and individuals affected by the disaster in the area. This research aims to explore the challenges, strengths, and lessons learned from the response to the Khoy earthquake in Iran.

Results
After conducting 40 interviews and achieving data saturation, we extracted experiences and lessons learned to investigate the performance of responsible organizations in the 2022 Khoy earthquake. The obtained data were categorized into 8 categories and 39 sub-categories. These categories encompassed warning and calling forces, disaster assessment, disaster commanding, emergency housing, supply and distribution of items, organization, and guidance of public participation and charities, psychological support, logistics operations, monitoring, evaluation, documentation, information dissemination, and media management. Planners and operational managers can use the findings to review and revise their action and prevention plans.
APP dyshomeostasis in the pathogenesis of Alzheimer’s disease: implications for current drug targets
Authors: Sirisi Sònia , Sánchez-Aced Érika , Belbin Olivia , Lleó Alberto 
Published: July 2024

AbstractThe Amyloid precursor protein (APP) is a transmembrane glycoprotein from which amyloid-β (Aβ) peptides are generated after proteolytic cleavage. Aβ peptides are the main constituent of amyloid plaques in Alzheimer’s Disease (AD). The physiological functions of APP in the human adult brain are very diverse including intracellular signaling, synaptic and neuronal plasticity, and cell adhesion, among others. There is growing evidence that APP becomes dysfunctional in AD and that this dyshomeostasis may impact several APP functions beyond Aβ generation. The vast majority of current anti-amyloid approaches in AD have focused on reducing the synthesis of Aβ or increasing the clearance of brain Aβ aggregates following a paradigm in which Aβ plays a solo in APP dyshomeostasis. A wider view places APP at the center stage in which Aβ is an important, but not the only, factor involved in APP dyshomeostasis. Under this paradigm, APP dysfunction is universal in AD, but with some differences across different subtypes. Little is known about how to approach APP dysfunction therapeutically beyond anti-Aβ strategies. In this review, we will describe the role of APP dyshomeostasis in AD beyond Aβ and the potential therapeutic strategies targeting APP.
Knockdown of miR-155 alleviates skin damage in rats with chronic spontaneous urticaria by modulating the JAK/STAT signaling pathway
Authors: An Yue-peng , Yuan Rui , Wang Shan-shan , Yang Su-qing , Zhang Qing 
Published: July 2024

Abstract
Objective
The aim of this study was to investigate the role and mechanisms of miR-155 in chronic spontaneous urticaria (CSU).

Methods
The expression level of miR-155 in the skin tissues of patients with CSU and experimental rats were detected by RT-qPCR, followed by the measurement of the histamine release rate in the serum through the histamine release test. Besides, hematoxylin & eosin staining was used to observe the pathological changes of the skin tissues; Corresponding detection kits and flow cytometry to measure the changes of immunoglobulins, inflammatory cytokines and T cell subsets in the serum of rats in each group; and western blot to check the expression level of proteins related to JAK/STAT signaling pathway in the skin tissues.

Results
Knockdown of miR-155 reduced the number and duration of pruritus, alleviated the skin damage, and decreased the number of eosinophils in CSU rats. Moreover, knockdown of miR-155 elevated the serum levels of IgG and IgM, decreased the levels of IgA and inflammatory cytokines, and reduced the proportion of CD4 + and CD4 + CD25 + T cells, as well as the CD4+/CD8 + ratio in CSU rats. However, Tyr705 intervention could reverse the effects of knockdown of miR-155 on CSU model rats. Furthermore, we found that knockdown of miR-155 significantly reduced the protein expression of IRF-9, as well as the P-JAK2/JAK2 and P-STAT3/STAT3 ratios in the skin tissues of CSU rats.

Conclusion
Knockdown of miR-155 can alleviate skin damage and inflammatory responses and relieve autoimmunity in CSU rats by inhibiting the JAK/STAT3 signaling pathway.
Sigmoid and cecum colon volvulus: a case report
Authors: Charo Dilawer Chofan , Mohammad Fares Medhat , Ghmera Mahmoud Issam , Saker Batoul Aksam , Ghosnah Ayman Ali 
Published: June 2024

Abstract
Introduction
Colon volvulus is the twisting of a segment of colon on its mesenteric axis, which can lead to the obstruction of the lumen and the blood supply. Colon volvulus is common in “volvulus belt” countries and can involve the sigmoid (60–70%) and cecum (25–40%).

Case presentation
We report a case of a 47-year-old male, Alawites, who presented with bowel obstruction and dilated abdomen without any specific abdominal pain. Abdominal laparotomy showed both sigmoid and cecum volvulus with no signs of perforation or ischemia.

Discussion and conclusion
One of the possible risk factors of sigmoid colon volvulus is the length of the rectum and sigmoid, while mobile cecum is considered as a possible reason for cecum volvulus. The management remains controversial and is specific for every case, depending mainly on the vitality of the colonic walls and the general condition of the patient.
DUF3055 from Staphylococcus aureus adopts unique strategy for structural distinctiveness
Authors: Kim Hyo Jung , Kim Hyoun Sook 
Published: July 2024

AbstractStaphylococcus aureus remains a public health threat with the WHO classifying the pathogen as a high priority in the development of new antimicrobial agents. Whole genome sequencing has revealed a number of conserved genes that may be essential for cell viability and infection. Characterising the structure and function of these proteins will inevitably aid development of new antimicrobials. Therefore, this study elucidated the structure of hypothetical protein DUF3055 from S. aureus stain Mu50. The protein possesses an as yet undefined function and a unique fold. The size of DUF3055 made it an ideal candidate for NMR characterisation which in conjunction with circular dichroism revealed the protein to be folded. Crystallisation and structural solution found that the overall dimer fold has a negatively charged surface formed by a β-bulge and tightly crossed α-helices, with a complementary size to a DNA single turn. Our structural observations suggest that hypothetical protein DUF3055 from S. aureus has a role in DNA binding and gene regulation.
Uncovering insights from big data: change point detection of classroom engagement
Authors: Nakamura Kohei , Ishihara Manabu , Horikoshi Izumi , Ogata Hiroaki 
Published: July 2024

AbstractExpectations of big data across various fields, including education, are increasing. However, uncovering valuable insights from big data is like locating a needle in a haystack, and it is difficult for teachers to use educational big data on their own. This study aimed to understand changes in student participation rates during classes and teachers’ teaching styles by analyzing educational big data. In the analysis, data from 120 students and two mathematics class teachers at a public junior high school in Japan were used. We applied the pruned exact linear time (PELT) algorithm to automatically identify significant changes in student participation during class. Based on the information obtained, we analyzed the interaction logs of teachers’ e-book readers and clarified the relationship between student participation rates and teacher behavior patterns. Change point detection using the PELT algorithm showed a high F1-score of 0.7929, indicating good overall performance. We also investigated whether there was a relationship between class differences and teachers’ actions and found a statistically significant difference. The results provide clues for improving student learning engagement and teachers’ teaching styles, and they are expected to improve the quality of education by automatically identifying notable cases from educational big data. However, further research is required to improve data analysis methods, such as adjusting the parameters of algorithms based on the situation.
Does ‘sub-threshold’ ventilatory stress promote healing after lung injury?
Authors: Marini John J. , Kummer Rebecca L. , Rocco Patricia R. M. 
Published: July 2024

AbstractExcessive tidal stretching may initiate damage or retard healing after lung injury. However, it is seldom considered whether intracycle power and ventilatory forces of lesser magnitude than those required to cross an injury threshold might stimulate or accelerate beneficial adaptive responses. Acute lung injury is a dynamic process that may exhibit phase-dependent reparative responses to mechanical stress broadly similar to physical training, body trauma or sepsis. We propose that lower stress may not always be better through all phases of ARDS; moderately high tidal airway pressures that stay below the threshold of global injury may have potential to speed healing of the injured lung.
Investigation of fingolimod-induced lymphocyte sequestration on inflammatory response and neurological damages after cardiac arrest
Authors: Abi Zeid Daou Yara , Lidouren Fanny , Bois Antoine , Watanabe Naoto , Jendoubi Ali , Faucher Estelle , Surenaud Mathieu , Chateau-Joubert Sophie , Hue Sophie , Ghaleh Bijan , Kohlhauer Matthias , Tissier Renaud 
Published: July 2024

Abstract
Background
A sepsis-like syndrome is known to occur after cardiac arrest, leading to cerebral infiltration by white blood cells (WBC). We hypothesized that pharmacological sequestration of WBC, and more specifically lymphocytes within lymphoid tissues, could reduce the cerebral infiltration by these inflammatory cells and subsequent acute brain injury in a porcine model of cardiac arrest. Lymphocyte sequestration was induced by the sphingosine-1 phosphate receptors agonist fingolimod.

Methods
In a first set of experiments, anesthetized pigs underwent a sham instrumentation with no cardiac arrest (n = 4). They received an administration of fingolimod (1 mg/kg, i.v.) in order to confirm its effect on WBC. In a second set of experiments, animals randomly received fingolimod or saline two hours prior to an episode of ventricular fibrillation (14 min) with subsequent resuscitation (n = 6 in each group). Neurological injury was assessed 24 h after resuscitation.

Results
In the first set of experiments, WBC and blood lymphocyte counts were significantly reduced by − 61 ± 10% and − 75 ± 6% two hours after fingolimod administration. In the second set of experiments, blood lymphocyte counts, but not WBC, were also significantly reduced after cardiac arrest in Fingolimod vs Control group. However, most cytokine blood levels were not different among groups, including Interleukin (IL)-1ra, IL-8 or IL-18 blood levels. A difference was only observed for IL-6, which decreased in Fingolimod vs Control (e.g., 5.6 ± 4.8 vs 59.4 ± 20.6 pg/ml at 2 h after cardiac arrest, respectively; p = 0.126). Neurofilament light chain (NFL) blood levels were not different among groups (57 ± 25 vs 84 ± 41 pg/ml in Fingolimod vs Control at 6 h after resuscitation, respectively). After awakening, 3 and 2 animals were prematurely euthanized for ethical reasons due to recurrent seizures in Fingolimod and Control groups, respectively. At Day 1, neurological dysfunction score was not different between groups (87 ± 7 vs 87 ± 5% in Fingolimod vs Control, respectively). Conversely, a decrease in the number of CD3 + cells was observed in the brain of surviving animals in Fingolimod vs Control group (3.10 ± 0.50 vs 7.53 ± 0.57 CD3 + cells/field, respectively; p = 0.0286).

Conclusion
Fingolimod-induced WBC sequestration, and more specifically lymphocytes sequestration, did not improve clinical neurological dysfunction following cardiac arrest although it reduced cerebral infiltration by lymphocytes.