bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatigue and physical activity in post-CABG patients: the parallel mediation model of kinesiophobia and self-efficacy : a prospective multicentre and cross-sectional study in China
Authors: Li Li , Piao Jing Jing , Shang Zhiyang 
Published: July 2024

ObjectivesThe objective of this study was to investigate how kinesiophobia and self-efficacy explain the relationship between fatigue and physical activity (PA) in post-coronary artery bypass grafting (post-CABG) patients over the age of 45.DesignA prospective multicentre and cross-sectional study.SettingThe study was conducted in four public tertiary hospitals in China.ParticipantsA total of 1278 patients who underwent CABG surgery were selected from the case pool, with their surgeries occurring between 3 and 19 months prior to selection. Out of 1038 patients who met the inclusion criteria and were invited to participate in the study, 759 patients agreed to participate and complete the questionnaire. Ultimately, 376 questionnaires were deemed eligible and included in the analysis.Primary and secondary outcome measuresThe questionnaire included the following scales: the Chinese version of the Multidimensional Fatigue Inventory (MFI-20), the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Cardiac Exercise Self-Efficacy Instrument (CESEI) and the International Physical Activity Questionnaire-Long (IPAQ-L). A serial mediation model was used to test whether the association between fatigue and PA was mediated by kinesiophobia and self-efficacy, in the overall sample and subsamples defined by age.ResultsThe results confirmed that fatigue was directly (95% CI (−5.73 to −3.02)) associated with PA. Higher kinesiophobia (95% CI (−0.16 to −0.05)) or lower PA self-efficacy (95% CI (−0.11 to −0.02)) were parallel pathways through which higher fatigue impediment reduced PA levels. In both subgroups, the street pathways of kinesiophobia and self-efficacy were altered. In the age, 45–60 years group, kinesiophobia (Boot 95% CI (−0.19 to−0.05)) was a mediator of fatigue on PA levels, while in the 61–75 years age group, self-efficacy (Boot 95% CI (−0.17 to −0.04)) was a mediator of fatigue on PA levels.ConclusionsA clear relationship between fatigue and PA was mediated by both kinesiophobia and self-efficacy. Furthermore, our findings highlight the importance of adapting the intervention according to the age of the patients, mainly by reducing patients’ kinesiophobia in patients aged 45–60 years and increasing patients’ self-efficacy in patients aged 61–75 years. It may be possible to improve PA levels in post-CABG patients over 45 years of age by eliminating kinesiophobia and increasing self-efficacy.
Cerina: cognitive–behavioural therapy-based mobile application for managing GAD symptoms among Ulster University Students in Northern Ireland – a protocol for a pilot feasibility randomised controlled trial
Authors: Eylem-van Bergeijk Ozlem , Poulter Siobhan , Ashcroft Kurtis , Robinson Tony , Mane Prasannajeet , Islam Momotaj , Condell Joan , Leavey Gerard 
Published: July 2024

IntroductionUniversity students are one of the most vulnerable populations for anxiety disorders worldwide. In Northern Ireland, anxiety disorders appear to be more common among the university student population due to the population demographics across the region. Despite the need, these students show less inclination to access the widely available on-campus well-being services and other external professional services. Digital cognitive–behavioural therapy (CBT) aims to bridge this gap between the need for psychological help and access to it. However, challenges such as limited reach, low adoption, implementation barriers and poor long-term maintenance are mainstay issues resulting in reduced uptake of digital CBT. As a result, the potential impact of digital CBT is currently restricted. The proposed intervention ‘Cerina’ is a scalable CBT-based mobile app with an interactive user interface that can be implemented in university settings if found to be feasible and effective.Methods and analysisThe study is a single-blind pilot feasibility randomised controlled trial aiming to test the feasibility and preliminary effects of Cerina in reducing Generalised Anxiety Disorder (GAD) symptoms. Participants are 90 Ulster University students aged 18 and above with self-reported GAD symptoms. They will be allocated to two conditions: treatment (ie, access to Cerina for 6 weeks) and a wait-list control group (ie, optional on-campus well-being services for 6 weeks). Participants in the wait-list will access Cerina 6 weeks after their randomisation and participants in both conditions will be assessed at baseline, at 3 (mid-assessment) and 6 weeks (postassessment). The primary outcome is the feasibility of Cerina (ie, adherence to the intervention, its usability and the potential to deliver a full trial in the future). The secondary outcomes include generalised anxiety, depression, worry and quality of life. Additionally, participants in both conditions will be invited to semistructured interviews for process evaluation.Ethics and disseminationEthical approval for the study has been granted by the Ulster University Research Ethics Committee (ID: FCPSY-22-084). The results of the study will be disseminated through publications in scientific articles and presentations at relevant conferences and/or public events.Trial registration numberNCT06146530.
INfluenza VaccInation To mitigate typE 1 Diabetes (INVITED): a study protocol for a randomised, double-blind, placebo-controlled clinical trial in children and adolescents with recent-onset type 1 diabetes
Authors: Pedersen Ida Borreby , Kjolby Mads , Hjelholt Astrid Johannesson , Madsen Mette , Christensen Ann-Margrethe Rønholt , Adolfsen Ditte , Hjelle Jesper Sand , Kremke Britta , Støvring Henrik , Jessen Niels , Vestergaard Esben Thyssen , Kristensen Kurt , Frobert Ole 
Published: July 2024

IntroductionChildren and adolescents with recent-onset type 1 diabetes (T1D) commonly maintain a certain level of insulin production during the remission phase, which can last months to years. Preserving β-cell function can reduce T1D complications and improve glycaemic control. Influenza vaccination has pleiotropic effects and administration of the vaccine during the early phases of T1D may offer β-cell protection. This study aims to assess the effect of influenza vaccination on preserving β-cell function in children and adolescents with recent-onset T1D.Methods and analysisThe INfluenza VaccInation To mitigate typE 1 Diabetes trial is a randomised, double-blind, placebo-controlled, multicentre trial in paediatric patients with recent-onset T1D aged 7–17 years. 100 participants will be randomised in a 1:1 ratio to receive either a standard inactivated quadrivalent influenza vaccine or a placebo within 14 days of diagnosis. The primary outcome is a difference in mean change (from baseline to 12 months) in C-peptide level between groups during a 2-hour mixed-meal tolerance test. Secondary outcomes include mean change (from baseline to 6 months) in C-peptide levels, haemoglobin A1c, ambulatory glucose profiles and insulin requirements. Exploratory outcomes are diabetes-related autoantibodies, inflammatory markers and serum haemagglutinin inhibition antibody titres against the influenza viruses. The current treatment for T1D is largely symptomatic, relying on insulin administration. There is a pressing need for novel pharmacological approaches aimed at modulating the immune system to preserve residual β-cell function. Existing immunotherapies are cost-prohibitive and associated with multiple side effects, whereas influenza vaccination is inexpensive and generally well tolerated. A positive outcome of this study holds potential for immediate implementation into standard care for children and adolescents with recent-onset T1D and may guide future research on immune modulation in T1D.Ethics and disseminationEthical approval was obtained from Danish Health Authorities prior to participant enrollment. The trial results will be submitted to a peer-reviewed journal.Trial registration numberClinicalTrials.govNCT05585983and EudraCT Number 2022-500906-17-01.
Person-centredness in dementia care: an integrative review of theoretical approaches
Authors: Serbser-Koal Jonathan , Rommerskirch-Manietta Mike , Purwins Daniel , Roes Martina 
Published: July 2024

ObjectivesThis review identifies and examines theoretical approaches (components and objectives) to person-centred dementia care in order to obtain a better understanding of what is meant by the concept of person-centred dementia care.DesignFollowing the approach of Whittemore and Knafl, an integrative literature review was conducted to answer the following questions: (1) Which theoretical approaches to person-centred dementia care have been published? (2) What are the components of the theoretical approaches to person-centred dementia care thus identified, and which objectives can be identified?Data sourcesMEDLINE (via PubMed), CINAHL (via EBSCO) and PsycINFO (via EBSCO) were searched through to 26 April 2021.Eligibility criteriaWe included any kind of published literature that describes theoretical approaches to person-centred dementia care and that was written in German or English.Data extraction and synthesisTwo independent reviewers extracted data. Data were pooled using a data extraction form developed by the Joanna Briggs Institute. A qualitative content analysis was conducted.ResultsThe analysis revealed heterogeneous perspectives within the identified approaches to person-centred dementia care. Statements pertaining to the components and objectives could be assigned to three different subcategories (microlevel, macrolevel and application level). This analysis enabled an enhanced understanding of how person-centred dementia care is currently described and whether and how the theoretical approaches differ in terms of their orientations and their focus on the individual and/or on sociality, which allows conclusions regarding the underlying conceptual idea of personhood.ConclusionsThere is a clear challenge for future research to overcome the dominance of the focus on the individual and to consider aspects of sociality to be at least equally important. This is needed in order to understand dementia as a multifaceted phenomenon that demands a differentiated consideration of theoretical notions of how to understand personhood in this context.
Pan-RAF:MEK Molecular Glues Take Center Stage
Authors: Hangauer Matthew J. , Gutkind Jorge Silvio , Ferguson Fleur M. 
Published: July 2024

Summary:In this issue, Ryan and colleagues describe the preclinical development of a pan-RAF:MEK molecular glue with superior efficacy, brain penetrance, and tolerability in xenograft models of Ras/Raf/MAPK pathway–driven tumors.See related article by Ryan et al., p. 1190 (1).
Circulating Metabolite Profiles and Risk of Coronary Heart Disease Among Racially and Geographically Diverse Populations
Authors: Deng Kui , Gupta Deepak K. , Shu Xiao-Ou , Lipworth Loren , Zheng Wei , Cai Hui , Cai Qiuyin , Yu Danxia 
Published: July 2024

BACKGROUND:
Metabolomics may reveal novel biomarkers for coronary heart disease (CHD). We aimed to identify circulating metabolites and construct a metabolite risk score (MRS) associated with incident CHD among racially and geographically diverse populations.

METHODS:
Untargeted metabolomics was conducted using baseline plasma samples from 900 incident CHD cases and 900 age-/sex-/race-matched controls (300 pairs of Black Americans, White Americans, and Chinese adults, respectively), which detected 927 metabolites with known identities among ≥80% of samples. After quality control, 896 case-control pairs remained and were randomly divided into discovery (70%) and validation (30%) sets within each race. In the discovery set, conditional logistic regression and least absolute shrinkage and selection operator over 100 subsamples were applied to identify metabolites robustly associated with CHD risk and construct the MRS. The MRS-CHD association was evaluated using conditional logistic regression and the C-index. Mediation analysis was performed to examine if MRS mediated associations between conventional risk factors and incident CHD. The results from the validation set were presented as the main findings.

RESULTS:

Twenty-four metabolites selected in ≥90% of subsamples comprised the MRS, which was significantly associated with incident CHD (odds ratio per 1 SD, 2.21 [95% CI, 1.62–3.00] after adjusting for sociodemographics, lifestyles, family history, and metabolic health status). MRS could distinguish incident CHD cases from matched controls (C-index, 0.69 [95% CI, 0.63–0.74]) and improve CHD risk prediction when adding to conventional risk factors (C-index, 0.71 [95% CI, 0.65–0.76] versus 0.67 [95% CI, 0.61–0.73];
P
<0.001). The odds ratios and C-index were similar across subgroups defined by race, sex, socioeconomic status, lifestyles, metabolic health, family history, and follow-up duration. The MRS mediated large portions (46.0%–74.2%) of the associations for body mass index, smoking, diabetes, hypertension, and dyslipidemia with incident CHD.

CONCLUSIONS:
In a diverse study sample, we identified 24 circulating metabolites that, when combined into an MRS, were robustly associated with incident CHD and modestly improved CHD risk prediction beyond conventional risk factors.
Systemic Deletion of ARRDC4 Improves Cardiac Reserve and Exercise Capacity in Diabetes
Authors: Nakayama Yoshinobu , Kobayashi Satoru , Masihuddin Aliya , Abdali Syed Amir , Seneviratne A.M. Pramodh Bandara , Ishii Sachiyo , Iida Jun , Liang Qiangrong , Yoshioka Jun 
Published: July 2024

BACKGROUND:
Exercise intolerance is an independent predictor of poor prognosis in diabetes. The underlying mechanism of the association between hyperglycemia and exercise intolerance remains undefined. We recently demonstrated that the interaction between ARRDC4 (arrestin domain-containing protein 4) and GLUT1 (glucose transporter 1) regulates cardiac metabolism.

METHODS:
To determine whether this mechanism broadly impacts diabetic complications, we investigated the role of ARRDC4 in the pathogenesis of diabetic cardiac/skeletal myopathy using cellular and animal models.

RESULTS:

High glucose promoted translocation of MondoA into the nucleus, which upregulated
Arrdc4
transcriptional expression, increased lysosomal GLUT1 trafficking, and blocked glucose transport in cardiomyocytes, forming a feedback mechanism. This role of
ARRDC4
was confirmed in human muscular cells from type 2 diabetic patients. Prolonged hyperglycemia upregulated myocardial
Arrdc4
expression in multiple types of mouse models of diabetes. We analyzed hyperglycemia-induced cardiac and skeletal muscle abnormalities in insulin-deficient mice. Hyperglycemia increased advanced glycation end-products and elicited oxidative and endoplasmic reticulum stress leading to apoptosis in the heart and peripheral muscle. Deletion of
Arrdc4
augmented tissue glucose transport and mitochondrial respiration, protecting the heart and muscle from tissue damage. Stress hemodynamic analysis and treadmill exhaustion test uncovered that
Arrdc4
-knockout mice had greater cardiac inotropic/chronotropic reserve with higher exercise endurance than wild-type animals under diabetes. While multiple organs were involved in the mechanism, cardiac-specific overexpression using an adenoassociated virus suggests that high levels of myocardial
ARRDC4
have the potential to contribute to exercise intolerance by interfering with cardiac metabolism through its interaction with GLUT1 in diabetes. Importantly, the
ARRDC4
mutation mouse line exhibited greater exercise tolerance, showing the potential therapeutic impact on diabetic cardiomyopathy by disrupting the interaction between ARRDC4 and GLUT1.

CONCLUSIONS:
ARRDC4 regulates hyperglycemia-induced toxicities toward cardiac and skeletal muscle, revealing a new molecular framework that connects hyperglycemia to cardiac/skeletal myopathy to exercise intolerance.
Evaluation of an in-use chest CT protocol in lung cancer screening - A single institutional study
Authors: Naimi Salma , Tetteh Mercy Afadzi , Ashraf Haseem , Johansen Safora 
Published: July 2024

Background Lung cancer is the most common cause of cancer-related death worldwide and therefore there has been a growing demand for low-dose computed tomography (LDCT) protocols. Purpose To investigate and evaluate the dose and image quality of patients undergoing lung cancer screening (LCS) using LDCT in Norway. Materials and Methods Retrospective dosimetry data, volumetric CT dose index (CTDIvol) and dose-length product (DLP), from 70 average-size and 70 large-size patients who underwent LDCT scan for LCS were included in the survey. Effective dose and size-specific dose were calculated for each examination and were compared with the American Association of Physicists in Medicine (AAPM) requirement. For a quantitative image quality analysis, noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were determined for different regions in the chest with two iterative reconstruction techniques, iDose and Iterative Model Reconstruction. Differences in dose and image quality between average-size and large-size patients were evaluated by Independent sample t test, and Wilcoxon signed rank test within the same patient group. Results The independent sample t test revealed significant differences ( p < .05) in dose values between average-size and large-size patients. Mean CTDIvol and DLP for average-size patients were 2.8 mGy and 115 mGy.cm, respectively, with appropriate increment for the large-size patients. Image quality (image noise, SNR, and CNR) did not significantly differ between patient groups when images were reconstructed with a model based iterative reconstruction algorithm. Conclusion The screening protocol assessed in this study resulted in CTDIvol values that were compliant with AAPM recommendation. No significant differences in objective image quality were found between patient groups.
Cuticle deposition ceases during strawberry fruit development
Authors: Straube Jannis , Hurtado Grecia , Zeisler-Diehl Viktoria , Schreiber Lukas , Knoche Moritz 
Published: July 2024

Abstract
Background
Ideally, the barrier properties of a fruit’s cuticle persist throughout its development. This presents a challenge for strawberry fruit, with their rapid development and thin cuticles. The objective was to establish the developmental time course of cuticle deposition in strawberry fruit.

Results
Fruit mass and surface area increase rapidly, with peak growth rate coinciding with the onset of ripening. On a whole-fruit basis, the masses of cutin and wax increase but on a unit surface-area basis, they decrease. The decrease is associated with marked increases in elastic strain.
The expressions of cuticle-associated genes involved in transcriptional regulation (FaSHN1, FaSHN2, FaSHN3), synthesis of cutin (FaLACS2, FaGPAT3) and wax (FaCER1, FaKCS10, FaKCR1), and those involved in transport of cutin monomers and wax constituents (FaABCG11, FaABCG32) decreased until maturity. The only exceptions were FaLACS6 and FaGPAT6 that are presumably involved in cutin synthesis, and FaCER1 involved in wax synthesis. This result was consistent across five strawberry cultivars.
Strawberry cutin consists mainly of C16 and C18 monomers, plus minor amounts of C19, C20, C22 and C24 monomers, ω-hydroxy acids, dihydroxy acids, epoxy acids, primary alcohols, carboxylic acids and dicarboxylic acids. The most abundant monomer is 10,16-dihydroxyhexadecanoic acid. Waxes comprise mainly long-chain fatty acids C29 to C46, with smaller amounts of C16 to C28. Wax constituents are carboxylic acids, primary alcohols, alkanes, aldehydes, sterols and esters.

Conclusion
The downregulation of cuticle deposition during development accounts for the marked cuticular strain, for the associated microcracking, and for their high susceptibility to the disorders of water soaking and cracking.
Urdu translation and cross-cultural validation of the stroke self-efficacy questionnaire
Authors: Uroose Waffa , Ikram Mehwish , Ikram Maryam , Shaki ur Rehman Syed , Asif Marvi , Javed Hafiza Rabia 
Published: July 2024

Abstract
Background
The Stroke Self-Efficacy Questionnaire (SSEQ) measures the self-confidence of the individual in functional activities after a stroke. The SSEQ is a self-report scale with 13 items that assess self-efficacy after a stroke in several functional domains.

Objective
The purpose was to translate the Stroke Self-Efficacy Questionnaire into Urdu Language and to find out the validity and reliability of Urdu SSEQ among stroke patients.

Methods
The cross-cultural validation study design was used. Following COSMIN guidelines, forward and backward translation protocols were adopted. After pilot testing on 10 stroke patients, the final Urdu version was drafted. A sample of 110 stroke patients was used to evaluate the validity and reliability of the SSEQ-U. Content and Concurrent validity were determined. The intraclass correlation coefficient and Cronbach’s alpha were used to measure internal consistency and test-retest reliability. Data analysis was performed using SPSS 25.

Results
The final version was drafted after application on 10 stroke patients. Content validity was analyzed by a content validity index ranging from 0.87 to 1. The internal consistency was calculated by Cronbach’s alpha (α > 0.80). Test-retest reliability was determined by the Intra-class correlation coefficient (ICC2,1=0.956). Concurrent validity was determined by correlations with other scales by using the Spearman correlation coefficient; moderate to strong correlations (positive and negative) were found with the Functional Independence Measure (r = 0.76), Beck Depression Inventory (r=-0.54), Short Form of 12-item Scale (r = 0.68) and Fall Efficacy Scale (r = 0.82) with p < 0.05.

Conclusion
The Urdu version was linguistically acceptable and accurate for stroke survivors for determining self-efficacy. It showed good content and concurrent validity, internal consistency and test-retest reliability.
Prevalence and risk factors of food insecurity among Syrian refugees in Türkiye
Authors: Esin Kübra , Işık Tülay , Ayyıldız Feride , Koc Mustafa , Vatanparast Hassan 
Published: July 2024

Abstract
Background
Although Türkiye (Turkey) hosts the largest number of Syrian refugees, studies on food insecurity are limited. This study examined the prevalence and risk factors of food insecurity among Syrian refugees living in Istanbul, which has the highest number of refugees in Türkiye.

Methods
A cross-sectional survey was conducted among Syrian refugees in Istanbul between September 2021 and March 2022. The main income earners of 103 households were interviewed by a research dietitian, with the assistance of an Arabic speaking interpreter through hour-long face-to-face. Data on sociodemographic characteristics (age, gender, nationality, marital status, educational status, the family income, the major source of family income, and the number of family members living in the household etc.) and household food insecurity status were collected. Household food insecurity status was assessed with the eighteen-item Household Food Security Survey Module.

Results
The household food insecurity rate was 90.3%, and those of adults and children were 88.4% and 84.8%, respectively. It was observed that family income level was significantly associated with food insecurity. A one-unit increase in monthly income increased food security by 0.02 times (p < 0.001). The number of employed refugees in the food security group was higher than that in the food insecurity group (p = 0.018). A significant difference was found in the rate of occupation type of the major income earner between the groups (p = 0.046).

Conclusions
High rates of food insecurity, particularly severe food insecurity, were found among Syrian refugees living in Istanbul. While more research is warranted to explore the root causes and efficacy of the current support system, it requires the immediate attention of policymakers at the national and international levels to implement effective policies and interventions.