bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical activity and psychological support can replace “another pill” to manage cancer-related symptoms in children and adolescents diagnosed with cancer
Authors: Caru Maxime , Levesque Ariane , Dandekar Smita , Schmitz Kathryn H. 
Published: April 2024

AbstractThe management of cancer-related symptoms with nonpharmacological treatment has been proven effective, but more studies are still required to strengthen the scientific evidence. Given the state of the evidence, one might wonder about the perceptions of pediatric oncology experts, healthcare providers and CAM providers regarding the use of supportive care in pediatric oncology. Related to this important question, Mora et al. recently published an exploratory qualitative study entitled “Supportive care for cancer-related symptoms in pediatric oncology: a qualitative study among healthcare providers” in the BMC Complementary Medicine and Therapies Journal. The data generated by the authors provided new insights and perspectives to the current literature. However, their findings must be put into perspective to increase the scope of the original article and to highlight that physical activity and psychosocial interventions are powerful nonpharmacological interventions to manage cancer-related symptoms.
The effect of peer mentoring program on clinical academic progress and psychological characteristics of operating room students: a parallel randomized controlled trial
Authors: Sedigh Amin , Bagheri Sara , Naeimi Pariya , Rahmanian Vahid , Sharifi Nader 
Published: April 2024

AbstractBackgroundOne of the new educational systems is the mentorship method. This study aimed to investigate the effect of peer mentoring program on clinical academic progress and psychological characteristics of operating room students.MethodsThis research was a randomized controlled trial that was conducted on undergraduate students in the operating room department of Khomein Faculty of Medical Sciences, Markazi Province in Iran. The number of operating room students were 70 that were divided into intervention and control groups by random allocation using Permuted Block Randomization. Inclusion criteria included all operating room students who were in internship, and exclusion criteria included failure to complete the questionnaires. The data collection tools were the demographic questionnaire, Depression Anxiety Stress Scale, Rosenberg Self-Esteem Scale and Situational Motivational Scale. In the control group, clinical training was done in the traditional way. In the intervention group, training was done by peer mentoring method. The obtained data were analyzed using descriptive statistics, independent t-test, paired t-test, chi-square test, ANCOVA, univariable and multivariable linear regression.ResultsThe study revealed significant differences between the intervention and control groups. Post-intervention, the intervention group demonstrated substantial increases in self-confidence (mean difference = 5.97,p < 0.001) and significant reductions in stress levels (mean difference = -3.22,p < 0.001). Conversely, minimal changes were noted in the control group for both self-confidence (mean difference = 0.057,p = 0.934) and stress levels (mean difference = 0.142,p = 0.656). Although both groups experienced decreases in anxiety and depression levels, these changes were not statistically significant (p > 0.05). Furthermore, the intervention significantly enhanced academic progress in the intervention group compared to the control group (mean difference = 20.31,p < 0.001).ConclusionThe results showed that the implementation of the peer mentoring program was effective in improving academic progress, self-confidence, and reducing the stress of operating room students. Therefore, this educational method can be used in addition to the usual methods to improve the education of operating room students.
Training nurses in an international emergency medical team using a serious role-playing game: a retrospective comparative analysis
Authors: Hu Hai , Lai Xiaoqin , Yan Longping 
Published: April 2024

Abstract
Background
Although game-based applications have been used in disaster medicine education, no serious computer games have been designed specifically for training these nurses in an IEMT setting. To address this need, we developed a serious computer game called the IEMTtraining game. In this game, players assume the roles of IEMT nurses, assess patient injuries in a virtual environment, and provide suitable treatment options.

Methods
The design of this study is a retrospective comparative analysis. The research was conducted with 209 nurses in a hospital. The data collection process of this study was conducted at the 2019-2020 academic year. A retrospective comparative analysis was conducted on the pre-, post-, and final test scores of nurses in the IEMT. Additionally, a survey questionnaire was distributed to trainees to gather insights into teaching methods that were subsequently analyzed.

Results
There was a significant difference in the overall test scores between the two groups, with the game group demonstrating superior performance compared to the control group (odds ratio = 1.363, p value = 0.010). The survey results indicated that the game group exhibited higher learning motivation scores and lower cognitive load compared with the lecture group.

Conclusions
The IEMT training game developed by the instructor team is a promising and effective method for training nurses in disaster rescue within IEMTs. The game equips the trainees with the necessary skills and knowledge to respond effectively to emergencies. It is easily comprehended, enhances knowledge retention and motivation to learn, and reduces cognitive load.
Nursing students’ readiness towards the ‘new normal’ in clinical practice: a distributed cognition qualitative perspective
Authors: Ang Wei How Darryl , Rusli Khairul Dzakirin Bin , Lau Ying , Lau Siew Tiang , Chew Han Shi Jocelyn 
Published: April 2024

AbstractBackgroundClinical practicums are a core component of baccalaureate nursing education. Following the coronavirus pandemic, there have been extensive changes in the workforce environment that may potentially affect nursing students’ experience and readiness for clinical practicums.MethodsA qualitative study was conducted to explore final-year nursing students’ experiences and readiness for their final clinical practicum before becoming a registered nurse. A purposive sample of 24 final-year baccalaureate nursing students was included in this study. Individual semi-structured interviews were conducted face-to-face via Zoom. The data was analysed using an inductive thematic analysis approach.ResultsThree themes depicting students’ experiences and clinical readiness were elucidated. The themes included: (1) Experiencing multiple concerns, (2) requiring a network of support, and (3) easing the transition to professional practice. Students considered the final clinical practicum as challenging and demanding which evoked numerous concerns.ConclusionsConsidering the stress that final-year nursing students experience, it will be important to devise strategies ranging from personal, relational, and environmental protective factors to enable their successful transition and completion of clinical practice.
Old people’s preference for nursing homes in East China: a discrete choice experiment
Authors: Zhong Yaqin , Guo Xiaojun , Liu Yitong , Wang Yaning , Wang Yanan , Song Yan , Lu Rujian 
Published: April 2024

Abstract
Background
The aged people who live in nursing home are predicted to keep growing in the following decades. There are both quantitative imbalance and structural imbalance in the utilization of nursing homes in China. This study aimed to analyze old people’s preference for nursing homes and help the government optimize resource allocation.

Methods
A discrete choice experiment (DCE) was conducted and six attributes of nursing homes including monthly fee, distance from home, geographical location, medical facilities, environment of nursing homes and nursing staff were determined. Respondents were recruited from Nantong and Yangzhou city, China. In each city, two communities or villages were randomly selected. In each community/village, about 65 old people were randomly selected. Analysis was conducted using mixed logit regression models to determine preferences for potential attributes.

Results
A total of 233 old people were included in the analysis. The findings indicated that all six attributes were statistically significant factors for participants. “Professional nursing staff” was the most important characteristic to participants, followed by “Medical facilities”. Compared with female, the males preferred professional nursing staff (β = 2.939 vs. β = 2.643, P < 0.001), medical facilities (β = 1.890 vs. β = 1.498, P < 0.001), and the environment (β = 0.752, P < 0.01). For different age groups, participants aged 60–69 didn’t pay attention to distance and location, while those aged 80 and above only paid attention to professional nursing staff and medical facilities.

Conclusions
The present study provides important insights into the characteristics of nursing home that are most preferred by old people. Authorities should take into account old people’s preference in the planning, design and evaluation of nursing homes.
The power of laughter: a study on humor and creativity in undergraduate nursing education in Egypt
Authors: El-Sayed Mona Metwally , AbdElhay Eman Sameh , Hawash Manal Mohammed , Taha Samah Mohamed 
Published: April 2024

Abstract
Background
Creativity in nursing education is crucial for developing practical problem-solving skills, and humor is a valuable tool for stress management and fostering a positive learning environment. This study explored the relationship between creativity and humor among nursing students.

Methods
A cross-sectional survey was conducted with 265 convenient undergraduate nursing students aged 20 to 25. The Short Scale of Creative Self (SSCS) and the Multidimensional Sense of Humor Scale (MSHS) were used to measure creativity and various aspects of humor.

Results
Showed a significant positive correlation between humor and creativity (r = 0.238, p < 0.001). Positive correlations were found between Humor Production, Coping or Adaptive Humor, and Appreciation of Humor with creativity (r = 0.254, 0.230, and 0.461, p < 0.001, respectively). In contrast, Attitudes Toward Humor and Humorous People were negatively correlated with creativity (r=-0.343, p < 0.05). Humor accounted for 16.2% of the variance in creativity.

Conclusion
The study concluded a strong link between humor and creativity, with positive correlations observed between creative self-efficacy and creative personal identity with different aspects of humor. The study recommends the incorporation of humor into nursing education and healthcare settings to encourage creative problem-solving and reduce burnout among students and staff.
Assessment of health literacy in a French emergency department
Authors: Marie Pauline , Romain-Scelle Nicolas , Potinet Veronique , Schott Anne Marie , Douplat Marion 
Published: April 2024

Abstract
Background
Health literacy (HL) has become a subject of major interest in public health worldwide. It is known to be linked to self-efficacy in care use and to global health status, and a non-negligible frequency of problematic or inadequate levels of HL in populations worldwide is reported. As this has yet to be evaluated in France, the present study aimed to evaluate the HL level of patients in a French emergency department (ED).

Methods
We conducted a descriptive, cross-sectional observational, single center study in the ED of the Lyon Sud hospital (Hospices civils de Lyon, Lyon, France). The primary endpoint was the HL level of the patients determined according to the score obtained using the 16-item European Health Literacy Survey Questionnaire. The secondary endpoint was the identification of sociodemographic factors associated with the HL level.

Results
A total of 189 patients were included for analysis. 10% (95% CI [3%; 17%]) of the patients had an inadequate HL, 38% (95% CI [31%; 45%]) had a problematic HL, and 53% (95% CI [46%; 61%] had an adequate HL. In multivariate analysis, age and perceived health status were independent predictors of the HL level; OR =0.82 (95% CI [0.69; 0.97]; p=0.026) for a 10-year increase in age, and OR =1.84 (95% CI [1.22; 2.82]; p=0.004]).

Conclusions
The HL level of the patients in the ED studied herein was similar to that found in the population of France and other European countries and was influenced by age and perceived health status, which are both associated with care needs. It may be therefore interesting to explore in future studies how taking into consideration HL in the general population may lead to a better self-efficacy in care and optimize the use of the healthcare system.
Analysis of cancer-associated fibroblasts related genes identifies COL11A1 associated with lung adenocarcinoma prognosis
Authors: Zheng Haosheng , Tan Jian , Qin Fei , Zheng Yuzhen , Yang Xingping , Qin Xianyu , Liao Hongying 
Published: April 2024

Abstract
Background
The treatment of lung adenocarcinoma is difficult due to the limited therapeutic options. Cancer-associated fibroblasts play an important role in the development of cancers. This study aimed to identify a promising molecular target associated with cancer-associated fibroblasts for the treatment of lung adenocarcinoma.

Methods
The Cancer Genome Atlas lung adenocarcinoma dataset was used to screen hub genes associated with cancer-associated fibroblasts via the EPIC algorithm and Weighted Gene Co-expression Network Analysis. Multiple databases were used together with our data to verify the differential expression and survival of COL11A1. Functional enrichment analysis and the single-cell TISCH database were used to elucidate the mechanisms underlying COL11A1 expression. The correlation between COL11A1 and immune checkpoint genes in human cancers was also evaluated.

Results
Using the EPIC algorithm and Weighted Gene Co-expression Network Analysis, 13 hub genes associated with cancer-associated fibroblasts in lung adenocarcinoma were screened. Using the GEPIA database, Kaplan-Meier Plotter database, GSE72094, GSE75037, GSE32863, and our immunohistochemistry experiment data, we confirmed that COL11A1 overexpresses in lung adenocarcinoma and that high expression of COL11A1 is associated with a poor prognosis. COL11A1 has a genetic alteration frequency of 22% in patients with lung adenocarcinoma. COL11A1 is involved in the extracellular matrix activities of lung adenocarcinoma. Using the TISCH database, we found that COL11A1 is mainly expressed by cancer-associated fibroblasts in the tumor microenvironment rather than by lung adenocarcinoma cells. Finally, we found that COL11A1 is positively correlated with HAVCR2(TIM3), CD274 (PD-L1), CTLA4, and LAG3 in lung adenocarcinoma.

Conclusion
COL11A1 may be expressed and secreted by cancer-associated fibroblasts, and a high expression of COL11A1 may result in T cell exhaustion in the tumor microenvironment of lung adenocarcinoma. COL11A1 may serve as an attractive biomarker to provide new insights into cancer therapeutics.
Targeting NLRP3 signaling reduces myocarditis-induced arrhythmogenesis and cardiac remodeling
Authors: Chin Chye-Gen , Chen Yao-Chang , Lin Fong-Jhih , Lin Yung-Kuo , Lu Yen-Yu , Cheng Tzu-Yu , Chen Shih-Ann , Chen Yi-Jen 
Published: April 2024

Abstract
Background
Myocarditis substantially increases the risk of ventricular arrhythmia. Approximately 30% of all ventricular arrhythmia cases in patients with myocarditis originate from the right ventricular outflow tract (RVOT). However, the role of NLRP3 signaling in RVOT arrhythmogenesis remains unclear.

Methods
Rats with myosin peptide–induced myocarditis (experimental group) were treated with an NLRP3 inhibitor (MCC950; 10 mg/kg, daily for 14 days) or left untreated. Then, they were subjected to electrocardiography and echocardiography. Ventricular tissue samples were collected from each rat’s RVOT, right ventricular apex (RVA), and left ventricle (LV) and examined through conventional microelectrode and histopathologic analyses. In addition, whole-cell patch-clamp recording, confocal fluorescence microscopy, and Western blotting were performed to evaluate ionic currents, intracellular Ca2+ transients, and Ca2+-modulated protein expression in individual myocytes isolated from the RVOTs.

Results
The LV ejection fraction was lower and premature ventricular contraction frequency was higher in the experimental group than in the control group (rats not exposed to myosin peptide). Myocarditis increased the infiltration of inflammatory cells into cardiac tissue and upregulated the expression of NLRP3; these observations were more prominent in the RVOT and RVA than in the LV. Furthermore, experimental rats treated with MCC950 (treatment group) improved their LV ejection fraction and reduced the frequency of premature ventricular contraction. Histopathological analysis revealed higher incidence of abnormal automaticity and pacing-induced ventricular tachycardia in the RVOTs of the experimental group than in those of the control and treatment groups. However, the incidences of these conditions in the RVA and LV were similar across the groups. The RVOT myocytes of the experimental group exhibited lower Ca2+ levels in the sarcoplasmic reticulum, smaller intracellular Ca2+ transients, lower L-type Ca2+ currents, larger late Na+ currents, larger Na+–Ca2+ exchanger currents, higher reactive oxygen species levels, and higher Ca2+/calmodulin-dependent protein kinase II levels than did those of the control and treatment groups.

Conclusion
Myocarditis may increase the rate of RVOT arrhythmogenesis, possibly through electrical and structural remodeling. These changes may be mitigated by inhibiting NLRP3 signaling.
Association between diabetes mellitus and primary restenosis following endovascular treatment: a comprehensive meta-analysis of randomized controlled trials
Authors: Sun Xiaolei , Zhang Cheng , Ma Yarong , He Yanzheng , Zhang Xiaodong , Wu Jianbo 
Published: April 2024

Abstract
Importance
Diabetes mellitus (DM) is thought to be closely related to arterial stenotic or occlusive disease caused by atherosclerosis. However, there is still no definitive clinical evidence to confirm that patients with diabetes have a higher risk of restenosis.

Objective
This meta-analysis was conducted to determine the effect of DM on restenosis among patients undergoing endovascular treatment, such as percutaneous transluminal angioplasty (PTA) or stenting.

Data sources and study selection
The PubMed/Medline, EMBASE and Cochrane Library electronic databases were searched from 01/1990 to 12/2022, without language restrictions. Trials were included if they satisfied the following eligibility criteria: (1) RCTs of patients with or without DM; (2) lesions confined to the coronary arteries or femoral popliteal artery; (3) endovascular treatment via PTA or stenting; and (4) an outcome of restenosis at the target lesion site. The exclusion criteria included the following: (1) greater than 20% of patients lost to follow-up and (2) a secondary restenosis operation.

Data extraction and synthesis
Two researchers independently screened the titles and abstracts for relevance, obtained full texts of potentially eligible studies, and assessed suitability based on inclusion and exclusion criteria.. Disagreements were resolved through consultation with a third researcher. Treatment effects were measured by relative ratios (RRs) with 95% confidence intervals (CIs) using random effects models. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.

Main outcomes and measures
The main observation endpoint was restenosis, including > 50% stenosis at angiography, or TLR of the primary operation lesion during the follow-up period.

Results
A total of 31,066 patients from 20 RCTs were included. Patients with DM had a higher risk of primary restenosis after endovascular treatment (RR = 1.43, 95% CI: 1.25–1.62; p = 0.001).

Conclusions and relevance
This meta-analysis of all currently available RCTs showed that patients with DM are more prone to primary restenosis after endovascular treatment.
Unravelling immune microenvironment features underlying tumor progression in the single-cell era
Authors: Du Qilian , An Qi , Zhang Jiajun , Liu Chao , Hu Qinyong 
Published: April 2024

AbstractThe relationship between the immune cell and tumor occurrence and progression remains unclear. Profiling alterations in the tumor immune microenvironment (TIME) at high resolution is crucial to identify factors influencing cancer progression and enhance the effectiveness of immunotherapy. However, traditional sequencing methods, including bulk RNA sequencing, exhibit varying degrees of masking the cellular heterogeneity and immunophenotypic changes observed in early and late-stage tumors. Single-cell RNA sequencing (scRNA-seq) has provided significant and precise TIME landscapes. Consequently, this review has highlighted TIME cellular and molecular changes in tumorigenesis and progression elucidated through recent scRNA-seq studies. Specifically, we have summarized the cellular heterogeneity of TIME at different stages, including early, late, and metastatic stages. Moreover, we have outlined the related variations that may promote tumor occurrence and metastasis in the single-cell era. The widespread applications of scRNA-seq in TIME will comprehensively redefine the understanding of tumor biology and furnish more effective immunotherapy strategies.
Remnant cholesterol is an effective biomarker for predicting survival in patients with breast cancer
Authors: Shi Jinyu , Liu Tong , Liu Chenan , Zhang Heyang , Ruan Guotian , Xie Hailun , Lin Shiqi , Zheng Xin , Chen Yue , Zhang Qi , Zhang Xiaowei , Li Xiangrui , Liu Xiaoyue , Deng Li , Shi Han-Ping 
Published: April 2024

Abstract
Background
Breast cancer is the most common malignancy in women worldwide. The relationship between remnant cholesterol (RC) and the prognosis of patients with breast cancer has not been clearly reported. This study investigated the prognostic value of RC in predicting mortality in patients with breast cancer.

Methods
This study prospectively analysed 709 women patients with breast cancer from the Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) project. Restricted cubic splines were used to analyse the dose-response relationship between RC and breast cancer mortality. The Kaplan–Meier method was used to evaluate the overall survival of patients with breast cancer. A Cox regression analyses was performed to assess the independent association between RC and breast cancer mortality. Inverse probability of treatment weighting (IPTW) using the propensity score was used to reduce confounding. Sensitivity analysis was performed after excluding patients with underlying diseases and survival times shorter than one year.

Results
A linear dose-response relationship was identified between RC and the risk of all-cause mortality in patients with breast cancer (p = 0.036). Kaplan–Meier survival analysis and log-rank test showed that patients with high RC levels had poorer survival than those with low RC levels (p = 0.007). Univariate and multivariate Cox regression analyses showed that RC was an independent risk factor for mortality in women patients with breast cancer. IPTW-adjusted analyses and sensitivity analyses showed that CR remained a prognostic factor.

Conclusions
RC is an independent risk factor for the prognosis of patients with breast cancer, and patients with higher RC levels have poorer survival.