bluuebunny/crossref_metadata_2025_split huggingface dataset:
Daily versus fortnightly oral vitamin D3 in treatment of symptomatic vitamin D deficiency in children aged 1−10 years: An open labelled randomized controlled trial
Authors: Mondal Kumar Arghya Prasanna , Singh Preeti , Singh Ritu , Malhotra Rajeev Kumar , Seth Anju 
Published: August 2024

AbstractObjectiveCompare the efficacy and safety of daily versus fortnightly oral vitamin D3 in treating symptomatic vitamin D deficiency in children aged 1−10 years.DesignOpen labelled randomized controlled trial.PatientsEighty children with symptomatic vitamin D deficiency were randomized into group daily (D) and group bolus (B) [40 in each group] to receive oral vitamin D3, 4000 IU daily or 60,000 IU fortnightly for 12 weeks respectively. Both groups received daily oral calcium of 500 mg/day.MeasurementsSerum calcium (Ca), phosphate (P), alkaline phosphatase (ALP), 25‐hydroxy cholecalciferol (25(OH)D), parathyroid hormone (PTH) levels, urine calcium: creatinine ratio and radiological score were assessed at baseline, 4 weeks and 12 weeks. At the end of 12 weeks, 74 children were available for evaluation of the efficacy and safety of both regimens.ResultsBoth regimens led to a significant increase in Ca and P levels and a fall in ALP and PTH levels from baseline to 4 and 12 weeks of therapy, with no intergroup difference. At 4‐ and 12‐week assessments, all children in both treatment arms achieved 25(OH)D level in sufficiency range, with no significant difference in their geometric mean.Both regimens were associated with asymptomatic transient hypercalcemia [group D—51.4% vs. group B—34.3%; p −0.14] and hypercalciuria (5.7%) in group D that resolved spontaneously on follow‐up.ConclusionsDaily and fortnightly oral vitamin D3 in similar cumulative doses are efficacious for treating symptomatic vitamin D deficiency in children (1−10 years). Treated children should be monitored for serum 25(OH)D, Ca and urinary calcium creatinine ratio.
Role of the circRNA_34414/miR‐6960a‐5p/SIRT3 axis in postoperative delirium via CA1 Vglut1+ neurons in older mice
Authors: Wang Hai‐Bi , Liu Qiang , Liu Yan‐Ping , Dong Wei , Wan Jie , Jiao Xin‐Hao , Wu Yu‐Qing , Li Tian‐Zuo , Miao Hui‐Hui 
Published: August 2024

AbstractAimsPostoperative delirium (POD) is a common neurological complication in elderly patients after anesthesia/surgery. The main purpose of this study is to explore the effect of circRNA‐targeted miRNA regulating SIRT3 on mitochondrial function through ceRNA mechanism under the surgical model of tibial fracture and to further explore the potential mechanism of postoperative delirium mediated by circRNA, so as to provide new ideas for clinical diagnosis and prevention of POD.MethodsThe surgical model of tibial fracture under sevoflurane anesthesia caused acute delirium‐like behavior in elderly mice. We observed that the decrease of SIRT3 and mitochondrial dysfunction was related to POD, and miRNA and circRNA (circRNA_34414) related to SIRT3 were further studied. Through luciferase and RAP, we observed that circRNA_34414, as a miRNA sponge, was involved in the regulation of SIRT3 expression.ResultsPostoperative delirium in elderly mice showed decreased expression of hippocampal circRNA_34414, increased expression of miR‐6960‐5p, decreased expression of SIRT3, and impaired mitochondrial membrane potential. Overexpression of circRNA_34414, or knockdown of miR‐6960‐5p, or overexpression of SIRT3 in hippocampal CA1 glutamatergic neurons significantly upregulated hippocampal SIRT3 expression, increased mitochondrial membrane potential levels, and significantly ameliorated postoperative delirium in aged mice; CircRNA_34414 ameliorates postoperative delirium in mice, possibly by targeting miR‐6960‐5p to upregulate SIRT3.ConclusionsCircRNA_34414 is involved in the improvement of postoperative delirium induced by anesthesia/surgery by upregulating SIRT3 via sponging miR‐6960‐5p.
Screening and early intervention for substance use during pregnancy: A retrospective case note review of antenatal care records
Authors: Stevens Matthew W. R. , Cooper Megan , Cusack Lynette , Ali Robert L. , Holmwood Chris , Briley Annette L. 
Published: August 2024

AbstractIntroductionScreening for substance use during pregnancy is critical for enhancing maternal health and perinatal outcomes. However, disparities persist in screening and intervention rates within maternity services. This retrospective case note review explored contemporaneous practices around screening and interventions for substance use among pregnant women during routine antenatal care.MethodsA random sample of 100 sets of maternity records were reviewed. Eligible cases included any woman attending initial pregnancy assessments at one of two South Australian metropolitan Hospital‐based antenatal clinics, from July 2019–September 2020. Screening rates for past and current alcohol, tobacco and other substance use were identified and compared with data from a subset of a nationally representative survey. Intervention details and referral pathways were also assessed.ResultsThe final sample of eligible cases (n = 93) demonstrated prioritisation of screening for current use, over past use, across all substances (p < 0.001). Screening was most likely for tobacco and least likely for e‐cigarettes (p < 0.001). Significant underreporting of past use compared with the benchmark was identified for all substances (except tobacco, p = 0.224). Interventions typically involved written resources, which were usually declined by clients.Discussion and ConclusionsDespite longstanding recommendations, screening and intervention practices for substance use appear inconsistent. With the recent emergence of vaping, no evidence of updated approaches to identifying e‐cigarette consumption in pregnant women was found. Several opportunities for enhancing routine screening and intervention practices within antenatal clinics were identified, and will inform the development of policy directives, targeted training modules, and other resources for health professionals working in these services.
Barriers to early diagnosis of chronic kidney disease and use of sodium‐glucose cotransporter‐2 inhibitors for renal protection: A comprehensive review and call to action
Authors: Czupryniak Leszek , Mosenzon Ofri , Rychlík Ivan , Clodi Martin , Ebrahimi Fahim , Janez Andrej , Kempler Peter , Małecki Maciej , Moshkovich Evgeny , Prázný Martin , Sourij Harald , Tankova Tsvetalina , Timar Bogdan 
Published: August 2024

AbstractChronic kidney disease (CKD) affects approximately 13% of people globally, including 20%–48% with type 2 diabetes (T2D), resulting in significant morbidity, mortality, and healthcare costs. There is an urgent need to increase early screening and intervention for CKD. We are experts in diabetology and nephrology in Central Europe and Israel. Herein, we review evidence supporting the use of sodium‐glucose cotransporter‐2 (SGLT2) inhibitors for kidney protection and discuss barriers to early CKD diagnosis and treatment, including in our respective countries. SGLT2 inhibitors exert cardiorenal protective effects, demonstrated in the renal outcomes trials (EMPA‐KIDNEY, DAPA‐CKD, CREDENCE) of empagliflozin, dapagliflozin, and canagliflozin in patients with CKD. EMPA‐KIDNEY demonstrated cardiorenal efficacy across the broadest renal range, regardless of T2D status. Renoprotective evidence also comes from large real‐world studies. International guidelines recommend first‐line SGLT2 inhibitors for patients with T2D and estimated glomerular filtration rate (eGFR) ≥20 mL/min/1.73 m2, and that glucagon‐like peptide‐1 receptor agonists may also be administered if required for additional glucose control. Although these guidelines recommend at least annual eGFR and urine albumin‐to‐creatinine ratio screening for patients with T2D, observational studies suggest that only half are screened. Diagnosis is hampered by asymptomatic early CKD and under‐recognition among patients with T2D and clinicians, including limited knowledge/use of guidelines and resources. Based on our experience and on the literature, we recommend robust screening programmes, potentially with albuminuria self‐testing, and SGLT2 inhibitor reimbursement at general practitioner (GP) and specialist levels. High‐tech tools (artificial intelligence, smartphone apps, etc.) are providing exciting opportunities to identify high‐risk individuals, self‐screen, detect abnormalities in images, and assist with prescribing and treatment adherence. Better education is also needed, alongside provision of concise guidelines, enabling GPs to identify who would benefit from early initiation of renoprotective therapy; although, regardless of current renal function, cardiorenal protection is provided by SGLT2 inhibitor therapy.
Exploring the therapeutic potential of Modafinil in mitigating renal ischemia–reperfusion injury in rats
Authors: Asli Fatemeh , Poshtdar Sepideh , Dehpour Ahmad Reza , Mohammad Jafari Razieh 
Published: August 2024

AbstractBackgroundRenal ischemia reperfusion injury (IRI) is a post‐ischemic event, which can lead to subsequent acute kidney injury (AKI), transplant failure, renal dysfunction and fibrosis via heightened oxidative stress and production of inflammatory cytokines and chemokines.ObjectiveThis study aims to assess the effect of Modafinil, a wake‐promoting agent with previously proven anti‐inflammatory and anti‐oxidative properties, on ameliorating renal IRI.MethodsA total of 30 male Wistar rats were divided into five groups: Sham‐operated group, ischemia reperfusion (I/R) control group and Modafinil pre‐treated groups (at different doses of 50, 100 and 150 mg/kg). IRI was induced by means of bilaterally clamping the renal arteries for 45 min, followed by 24 h of reperfusion.ResultsTissue pathological assessments demonstrated a reduction of glomerular, vascular and interstitial injury at doses of 50 and 100 mg/kg of Modafinil. The biochemical studies showed a significant decrease in tissue pro‐inflammatory factors, including tumor necrosis factor alpha (TNF‐α), Interleukin‐18 (IL‐18) and lactate dehydrogenase (LDH). Moreover, an elevation was observed in levels of super oxide dismutase (SOD) and catalase, indicating the reduction of oxidative stress. Furthermore, the levels of creatinine (Cr), urea and neutrophil gelatinase‐associated lipocalin (NGAL) were declined, indicating the improvement in renal function at effective doses of Modafinil (50 and 100 mg/kg) compared to the I/R control group without Modafinil pre‐treatment.ConclusionOur findings suggest that Modafinil holds promise as an effective therapeutic agent to address the clinical challenges associated with kidney IRI reducing the need for hospitalization and potentially alleviating related morbidities.
Reconstruction of artificial nuclei with nuclear import activity in living mouse oocytes
Authors: Yonezawa Nao , Shindo Tomoko , Oda Haruka , Kimura Hiroshi , Hiraoka Yasushi , Haraguchi Tokuko , Yamagata Kazuo 
Published: August 2024

AbstractIn eukaryotes, DNA is housed within the cell nucleus. Molecules required for the formation of a nucleus have been identified using in vitro systems with frog egg extracts and in vivo imaging of somatic cells. However, little is known about the physicochemical factors and conditions required for nuclear formation in mouse oocytes. In this study, using a reconstitution approach with purified DNA, we aimed to determine factors, such as the amount and timing of DNA introduction, required for the formation of nuclei with nuclear transport activity in mouse oocytes. T4 phage DNA (~166 kbp) was microinjected into strontium‐activated oocytes to evaluate the conditions appropriate for nuclear formation. Microinjection of 100–500 ng/μL of T4 DNA, but not 20 ng/μL, was sufficient for the formation of nucleus‐like structures. Furthermore, microinjection of DNA during metaphase II to telophase II, but not during interphase, was sufficient. Electron and fluorescence microscopy showed that T4 DNA‐induced nucleus‐like structures had nuclear lamina and nuclear pore complex structures similar to those of natural nuclei, as well as nuclear import activity. These results suggest that exogenous DNA can form artificial nuclei with nuclear transport functions in mouse oocytes, regardless of the sequence or source of the DNA.
Zinc transporter ZnT5 is associated with epithelial mesenchymal transition via SMAD1 in breast cancer
Authors: Iwabuchi Erina , Miki Yasuhiro , Xu Junyao , Kanai Ayako , Ishida Takanori , Sasano Hironobu , Suzuki Takashi 
Published: August 2024

AbstractZinc levels in breast cancer tissues have been reported to be higher than those in normal tissues. In addition, the expression levels of zinc transporters, including ZnT5 and ZnT6, are reportedly higher in breast cancer than in normal breast tissues. ZnT5 and ZnT6 also contribute to heterodimer formation and are involved in several biological functions. However, the functions of ZnT5 and ZnT6 heterodimers in breast cancer remain unknown. Therefore, we first investigated the immunolocalization of ZnT5 and ZnT6 in pathological breast cancer specimens and in MCF‐7 and T‐47D breast cancer cells. Next, we used small interfering RNA to assess cell viability and migration in ZnT5 knockdown MCF‐7 and T‐47D cells. Immunohistochemical analysis showed that the number of ZnT5‐positive breast cancer cells was inversely correlated with the pathologic N factor status. ZnT5 knockdown had no effect on cell viability in the presence of 100 μM ZnCl2 in MCF‐7 and T‐47D cells. In a wound healing assay, 100 μM ZnCl2 treatment inhibited cell migration of MCF‐7 and T‐47D cells, whereas ZnT5 knockdown promoted cell migration, decreased E‐cadherin expression and increased vimentin, slug and matrix metalloproteinase 9 expression. Antibody arrays showed that ZnT5 knockdown increased the expression of SMAD1, and that dorsomorphin treatment inhibited the promotion of migratory ability induced by ZnT5 knockdown. The results of this study revealed that both ZnT5 may be involved in less aggressive breast cancer subtypes, possibly through inhibition of cell migration.
Factors that influence the clinical supervision implementation for nurses: A scoping review
Authors: Ryu Hosu , Buus Niels , Naccarella Lucio , Zarb Lauren , Hamilton Bridget 
Published: August 2024

AbstractAimsThe aim of this review is to identify and map the evidence available on the factors that influence the implementation of clinical supervision for nurses.DesignThe scoping review was conducted and reported following the JBI methodology for scoping reviews.Data SourcesSearches were conducted on MEDLINE, PsycINFO, and CINAHL databases on 28 March 2023.Review MethodsA total of 1398 studies were imported into Covidence for screening. Researchers screened the papers according to the inclusion criteria. Empirical studies in English focusing on the implementation of clinical supervision for nurses were included, without year restrictions. Data from 16 studies were extracted and organized according to the constructs within the Consolidated Framework for Implementation Research (CFIR) domains: intervention characteristics, outer setting, inner setting, characteristics of individuals, and process.ResultsWhen compared with the CFIR constructs, it was found that the influence of the outer setting on implementation was less explored in the literature. Most of the reviewed data highlighted recurring factors, particularly logistical challenges of nursing work such as shift work and lack of control over work time. Organizational culture and managerial support were also identified as significant factors in the implementation. Another significant challenge in implementation was the variety in clinical supervision's design, purpose, and application, despite sharing the same label, leading to questions about whether studies are implementing the same practice.ConclusionPolicy documents should clearly define both the design and purpose of clinical supervision, beyond just its conceptual definition. Greater emphasis on equitable implementation of clinical supervision is necessary to prevent perpetuating existing inequalities. We conclude that implementation of such complex interventions is not linear, and the implementation strategies need to align with expected implementation challenges.ImpactThe advantage of using the implementation framework lies not only in observing what exists as a form of evidence but also in identifying what is underdeveloped. Healthcare services and policy developers can utilize our review to recognize and address potential challenges in introducing, modifying, scaling up, or sustaining their clinical supervision implementation.Patient or Public ContributionNo patient or public contribution.
Navigating the Uncertainties of Post‐disruption Dynamics in Discourse: A Case Study of the EU–UK Security Relationship After Brexit
Authors: Brusenbauch Meislová Monika 
Published: August 2024

AbstractThe article presents a model that conceptualizes the discursive construction of post‐disruption dynamics endorsed and reproduced by the affected parties and its potential to (not) contribute to future co‐operation. Conceiving of Brexit as a prime case of a broader phenomenon of post‐disruption contexts, this paper applies this model to the empirical case of the post‐Brexit European Union (EU)–United Kingdom (UK) security co‐operation in order to reveal how considerations on Brexit‐related re‐engagement and de‐engagement in the context of the EU–UK security relationship were discursively articulated by the UK government and the European Commission in the 2016–2023 period. The findings show that despite the lack of tangible actions and a seemingly continuous string of missed opportunities, the institutional discourse production has largely fulfilled an enabling function vis‐à‐vis potential future co‐operation. At the same time, this article highlights the lingering effects of Brexit‐triggered discord.
Impact of a clinical decision support system on identifying drug‐related problems and making recommendations to providers during community pharmacist‐led medication reviews in Ontario, Canada: A pilot study
Authors: Riley Karen , Yap Katherine , Foley Gaelan , Lambe John , Lund Sean 
Published: August 2024

AbstractObjectiveTo evaluate the impact of a clinical decision support system (CDSS) to identify drug‐related problems (DRPs) during community pharmacist medication reviews.DesignPilot 3‐phase (group), open‐label study.Setting and ParticipantsTwo community pharmacies in Sarnia, Ontario, with pharmacists providing medication reviews to patients.Study ProceduresFive pharmacists participated in three phases (groups). During Phase 1, pharmacists conducted medication reviews in 25 adult patients using the usual approaches. In Phase 2, pharmacists were trained to use a CDSS to identify DRPs, and then conducted medication reviews using the tool in a different group of 25 adult patients. In Phase 3, pharmacists conducted medication reviews without the aid of the CDSS in 25 additional adult patients.Main Outcome MeasuresThe primary outcome was recommendation to the primary care physician to alter pharmacotherapy based on medication review, assessed using mean number and frequency (yes/no) of recommendations by patient. Secondary outcomes included number of potential DRPs, actual DRPs, medication review duration time, pharmacist's perceptions of the CDSS and patient satisfaction with medication review.ResultsThe mean number of recommendations to primary care physicians to alter pharmacotherapy per patient in Phases 1, 2 and 3 did not differ: 1.0 (SD = I.2) versus 1.5 (1.0) versus 1.5 (1.0), respectively; p = 0.223. The percentage of patients with a pharmacy recommendation sent to physicians across the phases, however, differed: 52% versus 80% versus 88%, respectively; p = 0.010, with more in Phases 2 and 3 compared to 1. There were more potential DRPs in group 2 compared to other groups. There were no differences in actual DRPs and medication review time. Pharmacists had positive attitudes about the CDSS. Patients were generally satisfied with their medication review.ConclusionsThis small pilot study provides some preliminary evidence for performance and feasibility of a CDSS to identify DRPs that pharmacists will act on. Future research is recommended to validate these findings in a larger sample.
Health‐related quality of life and its association with disease activity/functional status in rheumatoid arthritis: A cross‐sectional study from South India
Authors: Haridoss Madhumitha , Bagepally Bhavani Shankara , Venkataraman Krishnamurthy , Purushothaman Sudha Rani 
Published: August 2024

AbstractBackgroundRheumatoid arthritis (RA) is an autoimmune disease with chronic pain that gradually becomes incapacitating and negatively influences the health‐related quality of life (HRQoL). This study estimates HRQoL in RA using the EuroQol five dimensions (EQ‐5D) tool and its association with functional status and disease activity.MethodsRA patients (n = 320) aged above 18 years, visiting outpatient clinic at a tertiary care multispecialty hospital in south India were the study participants. Sociodemographic, clinical, and laboratory data were collected from them. EQ‐5D‐5L questionnaire and the EQ Global Health Visual Analogue Scale (EQ‐VAS) were used to measure HRQoL. Disease activity was measured using Disease Activity Score‐28 (DAS‐28), and the Health Assessment Questionnaire (HAQ) was used to assess functional status. Pearson's correlation and multiple linear regression were used to measure association, and statistical significance was considered at p < 0.05.ResultsThe EQ‐5D utility score was 0.54 ± 0.36, pain and anxiety were the most affected domains, and the mean EQ‐VAS was 63.05 ± 18.54%. A moderate to high disease activity was present in 85% (DAS‐28 > 3.2), and a severe functional disability in 32.8% (HAQ > 1.5) of study participants. The mean EQ‐5D scores for RA patients were 0.78 (0.65–0.90) for no disease activity, 0.73 (0.65–0.80) for mild, 0.53 (0.32–0.74) for moderate and 0.47 (0.32–0.62) for high disease activity. In multiple linear regression analysis, HAQ and age independently predicted EQ‐5D.ConclusionRA significantly impacts HRQoL, and interventions focussing on pain and anxiety management are essential. The study's EQ‐5D values could help estimate Quality Adjusted Life Years (QALY) while conducting economic evaluation studies in RA within an Indian context.
Quality of care and patient satisfaction: Future trends and economic implications for the healthcare system
Authors: Perals Paula Ortega , Rambaud Salvador Cruz , García Javier Sánchez 
Published: August 2024

AbstractThe healthcare system is a fundamental pillar for the economy of any country. One of its main goals is to reach an adequate effectiveness of medical care so that certain levels of well‐being are achieved. In recent years, healthcare has experienced important changes to take into account quality of care and patient satisfaction as the drivers of effectiveness and financial performance. In this sense, it is specifically important to bring together in a single document all aspects that participate in the quality of care and patient satisfaction relationship. The purpose of this paper is to analyze, organize, and synthesize all the theories, methodologies, factors, and variables that conform to this relationship. To achieve that, a systematic literature review of 90 articles is performed. The main contributions of this paper are to reveal all factors and aspects relevant for the quality of care and patient satisfaction binomial, and the classification of impactful articles, methodological and theoretical approaches, leading journals, and variables of interest that exist in quality of care and patient satisfaction research. Eventually, important research gaps and further research lines are highlighted.