bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of retinal microvascular alterations with diabetes mellitus: an OCTA-based cross-sectional study
Authors: Yao Yao , Wang Qian , Yang Jingyan , Yan Yanni , Wei Wenbin 
Published: June 2024

Abstract
Background
Diabetes, a health crisis afflicting millions worldwide, is increasing rapidly in prevalence. The microvascular complications triggered by diabetes have emerged as the principal cause of renal disease and blindness. The retinal microvascular network may be sensitive to early systemic vascular structural and functional changes. Therefore, this research endeavored to discern the systemic determinants influencing the retinal microvascular network in patients with and without diabetes.

Methods
The Kailuan Eye Study is a cross-sectional study based on the community-based cohort Kailuan Study. Participants underwent optical coherence tomography angiography (OCTA) (Zeiss Cirrus 5000; Carl Zeiss Meditec) and comprehensive systemic examination. Metrics such as perfusion density (PD), vascular density (VD), foveal avascular zone (FAZ) parameters of the superficial capillary plexus (SCP) in the macula were assessed.

Results
This study included 860 eligible participants (average age = 62.75 ± 6.52 years; 21.9% female), of which 449 were diabetics. People with diabetes had diminished PD and VD in the entire macular and parafoveal regions compared to people without diabetes. Reduced PD in the whole macular region was correlated with higher fasting plasma glucose (FPG, mmol/L) concentration (Beta = -0.19, 95% CI = -0.42 to -0.36, P < 0.001), longer axial length (AL, mm) (Beta = -0.13, 95%CI = -0.48 to -0.25, P = 0.002), and elevated heart rate (Beta = -0.10, 95%CI = -0.14 to -0.19, P = 0.014), after adjusting for younger age (Beta = -0.18, 95%CI = -0.24 to -0.35, P < 0.001), consistent with VD of the whole macular region. A higher FPG level was significantly correlated with lower SCP density of both PD and VD in the macular and parafoveal region (P < 0.05 for all), as well as increased systolic blood pressure and low-density lipoprotein cholesterol concentration (P < 0.01 for all).

Conclusions
In this large-sample cross-sectional study, OCTA evaluation revealed that high prevalence of diabetes and elevated FPG levels were correlated with reduced retinal VD and PD. Hypertension and hyperlipidemia are important risk factors for the development of atherosclerotic cardiovascular disease but have no significant effect on retinal microvascular abnormalities.
Movement behaviour typologies and their associations with adiposity indicators in children and adolescents: a latent profile analysis of 24-h compositional data
Authors: Janda David , Gába Aleš , Hron Karel , Arundell Lauren , Contardo Ayala Ana Maria 
Published: June 2024

Abstract
Objectives
Growing evidence supports the important role of 24-hour movement behaviours (MB) in preventing childhood obesity. However, research to understand the heterogeneity and variability of MB among individuals and what kind of typologies of individuals are at risk of developing obesity is lacking. To bridge this gap, this study identified typologies of 24-hour MB in children and adolescents and investigated their associations with adiposity indicators.

Methods
In this cross-sectional study, 374 children and 317 adolescents from the Czech Republic wore wrist-worn accelerometers for seven consecutive days. Time spent in moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behaviour (SB), and sleep was quantified using raw accelerometery data. Adiposity indicators included body mass index (BMI) z-score, fat mass percentage (FM%), fat mass index (FMI), and visceral adipose tissue (VAT). Bias-adjusted latent profile analysis was used on the 24-hour MB data to identify MB typologies and their associations with adiposity indicators. The models were adjusted for potential confounders. The identified typologies were labelled to reflect the behavioural profiles of bees to aid interpretability for the general public.

Results
Two typologies were identified in children: highly active Workers characterised by high levels of MVPA and LPA, and inactive Queens characterised by low levels of MVPA and LPA, high levels of SB and longer sleep duration compared to Workers. In adolescents, an additional typology labelled as Drones was characterised by median levels of MVPA, LPA, SB and longest sleep duration. After controlling for covariates, we found that children labelled as Queens were associated with 1.38 times higher FM%, 1.43 times higher FMI, and 1.67 times higher VAT than Workers. In adolescents, Drones had 1.14 times higher FM% and Queens had 1.36 higher VAT in comparison with Workers, respectively.

Conclusion
Our study highlights the importance of promoting active lifestyles in children and adolescents to potentially reduce adiposity. These findings can provide insights for interventions aimed at promoting healthy MB and preventing childhood obesity.

Graphical Abstract
Unraveling agricultural water pollution despite an ecological policy in the Ayeyarwady Basin
Authors: Banda Lazarus Obed Livingstone , Banda Chigonjetso Victoria , Banda Jane Thokozani , Mwaene Eretia , Munthali George N. Chidimbah , Hlaing Thin Thin , Chiwosi Blessings 
Published: June 2024

Abstract
Background
The Ayeyarwady Basin in Myanmar, a critical economic zone, faces severe ecological degradation due to unsustainable agricultural practices. These practices pose significant threats to human health and marine biodiversity. Environmental threats persist despite the Myanmar government’s efforts to implement biodiversity protection policies. This research explores the limited compliance with environmental protection policies among farmers in the Ayeyarwady Basin and its implications for sustainable agricultural practices and ecological conservation.

Methods
This research employs an exploratory phenomenological approach, utilizing semi-structured, in-depth interviews with government officials and farmers (N = 30). The data collected were subjected to thematic analysis using Atlas 23.

Results
Preliminary findings reveal a gap in farmers’ awareness and understanding of these policies, hindered by insufficient financing, poor communication infrastructure, and uncoordinated policy monitoring. These factors and existing unrest contribute to a top-down policy approach that neglects frontline stakeholders. The study suggests the need for clear stakeholder roles, adequate policy financing, and diverse communication strategies to effectively implement environmental policies and protect human and marine life.

Conclusions
Environmental policy shortcomings in Myanmar are attributable to governmental oversight and insufficient stakeholder engagement. To mitigate pollution and safeguard river basin ecosystems, the government must delineate stakeholder responsibilities, allocate appropriate policy funding, and adopt varied communication approaches with farmers.

Graphical Abstract
Risk factor analysis and establishment of a nomogram model to predict blood loss during total knee arthroplasty
Authors: Liu Yikai , Ai Jiangshan , Teng Xue , Huang Zhenchao , Wu Haoshen , Zhang Zian , Wang Wenzhe , Liu Chang , Zhang Haining 
Published: June 2024

Abstract
Purpose
The risk factors for excessive blood loss and transfusion during total knee arthroplasty (TKA) remain unclear. The present study aimed to determine the risk factors for excessive blood loss and establish a predictive model for postoperative blood transfusion.

Methods
This retrospective study included 329 patients received TKA, who were randomly assigned to a training set (n = 229) or a test set (n = 100). Univariate and multivariate linear regression analyses were used to determine risk factors for excessive blood loss. Univariate and multivariate logistic regression analyses were used to determine risk factors for blood transfusion. R software was used to establish the prediction model. The accuracy and stability of the models were evaluated using calibration curves, consistency indices, and receiver operating characteristic (ROC) curve analysis.

Results
Risk factors for excessive blood loss included timing of using a tourniquet, the use of drainage, preoperative ESR, fibrinogen, HCT, ALB, and free fatty acid levels. Predictors in the nomogram included timing of using a tourniquet, the use of drainage, the use of TXA, preoperative ESR, HCT, and albumin levels. The area under the ROC curve was 0.855 (95% CI, 0.800 to 0.910) for the training set and 0.824 (95% CI, 0.740 to 0.909) for the test set. The consistency index values for the training and test sets were 0.855 and 0.824, respectively.

Conclusions
Risk factors for excessive blood loss during and after TKA were determined, and a satisfactory and reliable nomogram model was designed to predict the risk for postoperative blood transfusion.
Mechanical properties of combined packable and high-filled flowable composite used for the fixed retainer: an in vitro study
Authors: Alamdarloo Yasaman , Mosaddad Seyed Ali , Golfeshan Farzaneh 
Published: June 2024

Abstract
Background
Clinicians often utilize both flowable and packable composites concurrently in bonding fixed retainers. Thus, this study aimed to assess the synergistic effect of these composites in the bonding process.

Methods
This in vitro study divided specimens into three groups: flowable composite (nano-hybrid, Tetric N-Flow, Ivoclar Vivadent), packable composite (nano-hybrid, Tetric N-ceram, Ivoclar Vivadent), and combined use of flowable and packable composite. Shear bond strength (SBS), adhesive remnant index (ARI), and wire pull-out resistance were compared among the groups. Statistical analyses were conducted using ANOVA and Tukey tests to compare study groups. Additionally, Chi-square and Kruskal-Wallis tests were employed to analyze the ARI index among the groups.

Results
ANOVA results indicated no statistically significant differences among test groups (P = 0.129) regarding SBS. However, a significant difference existed between flowable and packable composite groups (P = 0.01) regarding ARI scores. Among the study groups, flowable composite exhibited the highest frequencies of ARI scores of 1 and 2, whereas packable composite showed the highest frequency of ARI scores of 0. The combined group had higher frequencies of ARI scores of 0 and 1 compared to the flowable composite. The wire pull-out test revealed that the combined application of flowable and packable composite resulted in significantly lower detachments compared to the packable composite alone (P = 0.008). However, no significant differences were observed in the comparisons between the flowable-packable (P = 0.522) and combined-flowable (P = 0.128) groups.

Conclusion
The combined use of flowable and packable composites for fixed retainers demonstrated adequate shear bond strength and ideal ARI scores, suggesting it as a suitable adhesive system for bonding orthodontic fixed retainers.
Challenges in recognizing and discussing changes in a resident’s condition in the palliative phase: focus group discussions with nursing staff working in nursing homes about their experiences
Authors: Bagchus C. , Zee M. S. , van der Steen J. T , Klapwijk M. S. , Dekker N. Lemos , Onwuteaka-Philipsen B. D. , Pasman H. R. W. 
Published: June 2024

Abstract
Background
Most nursing home residents have complex care needs, require palliative care and eventually die in these facilities. Timely recognition of changes in a resident’s condition is crucial for providing appropriate care. Observations by nursing staff play a significant role in identifying and interpreting these changes.

Methods
Focus group discussions were conducted with nursing staff from ten nursing homes in the Netherlands to explore their experiences and challenges in recognizing and discussing changes in a resident’s condition. These discussions were analysed following the principles of thematic analysis.

Results
The analysis of the challenges nursing staff face in identifying and interpreting changes in a resident’s condition, resulted in three themes. First, that recognizing changes is considered complex, because it requires specialized knowledge and skills that is generally not part of their education and must partly be learned in practice. This also depends on how familiar the nursing staff is with the resident. Furthermore, different people observe residents through different lenses, depending on their relation and experiences with residents. This could lead to disagreements about the resident’s condition. Lastly, organizational structures such as the resources available to document and discuss a resident’s condition and the hierarchy between nursing home professionals often hindered discussions and sharing observations.

Conclusion
Nursing staff’s experiences highlight the complexity of recognizing and discussing changes in nursing home residents’ conditions. While supporting the observational skills of nursing staff is important, it is not enough to improve the quality of care for nursing home residents with palliative care needs. As nursing staff experiences challenges at different, interrelated levels, improving the process of recognizing and discussing changes in nursing home residents requires an integrated approach in which the organization strengthens the position of nursing staff. It is important that their observations become a valued and integrated and part of nursing home care.
Mentor communication skills training: development, feasibility, and preliminary efficacy
Authors: Banerjee Smita C. , Parker Patricia A. , Staley Jessica M. , Manna Ruth , Mahoney Cassidy , Liberman Laura 
Published: June 2024

Abstract
Background
Mentoring is vital to career development in academic medicine, and communication underlies all aspects of the mentoring relationship. Although training research mentors has been shown to be effective, few academic medicine faculties have received training in how to mentor. The investigators developed a novel intervention, the Mentor Communication Skills Training for Oncology Faculty (“Comskil Mentor Training”) and examined feasibility and preliminary efficacy.

Methods
The study was a single arm pre-post intervention design. The intervention (Comskil Mentor Training) was offered in one virtual 3-hour session and included a didactic lecture with exemplary skill demonstration videos, facilitator-led small group role plays with trained actors, and evaluation. 19 faculty members from 12 departments participated in the training.

Results
All participants completed the training. Overall, the training was rated favorably, with more than 80% of participants indicating that they “agreed” or “strongly agreed” with training evaluation. From pre- to post-training, significant improvement was seen in participants’ overall self-efficacy to communicate with mentees, as well as participants’ overall use of communication skills and mentoring-specific language.

Conclusions
Our findings support the feasibility and preliminary efficacy of a virtually delivered experiential mentor communication skills training program for multidisciplinary clinical and research faculty in oncology.
PCYT1A deficiency disturbs fatty acid metabolism and induces ferroptosis in the mouse retina
Authors: Wang Kaifang , Xu Huijuan , Zou Rong , Zeng Guangqun , Yuan Ye , Zhu Xianjun , Zhao Xiaohui , Li Jie , Zhang Lin 
Published: June 2024

Abstract
Background
Inherited retinal dystrophies (IRDs) are a group of debilitating visual disorders characterized by the progressive degeneration of photoreceptors, which ultimately lead to blindness. Among the causes of this condition, mutations in the PCYT1A gene, which encodes the rate-limiting enzyme responsible for phosphatidylcholine (PC) de novo synthesis via the Kennedy pathway, have been identified. However, the precise mechanisms underlying the association between PCYT1A mutations and IRDs remain unclear. To address this knowledge gap, we focused on elucidating the functions of PCYT1A in the retina.

Results
We found that PCYT1A is highly expressed in Müller glial (MG) cells in the inner nuclear layer (INL) of the retina. Subsequently, we generated a retina-specific knockout mouse model in which the Pcyt1a gene was targeted (Pcyt1a-RKO or RKO mice) to investigate the molecular mechanisms underlying IRDs caused by PCYT1A mutations. Our findings revealed that the deletion of Pcyt1a resulted in retinal degenerative phenotypes, including reduced scotopic electroretinogram (ERG) responses and progressive degeneration of photoreceptor cells, accompanied by loss of cells in the INL. Furthermore, through proteomic and bioinformatic analyses, we identified dysregulated retinal fatty acid metabolism and activation of the ferroptosis signalling pathway in RKO mice. Importantly, we found that PCYT1A deficiency did not lead to an overall reduction in PC synthesis within the retina. Instead, this deficiency appeared to disrupt free fatty acid metabolism and ultimately trigger ferroptosis.

Conclusions
This study reveals a novel mechanism by which mutations in PCYT1A contribute to the development of IRDs, shedding light on the interplay between fatty acid metabolism and retinal degenerative diseases, and provides new insights into the treatment of IRDs.
Expanding community case management of malaria to all ages can improve universal access to malaria diagnosis and treatment: results from a cluster randomized trial in Madagascar
Authors: Garchitorena Andres , Harimanana Aina , Irinantenaina Judickaelle , Razanadranaivo Hobisoa Léa , Rasoanaivo Tsinjo Fehizoro , Sayre Dean , Gutman Julie R. , Mangahasimbola Reziky Tiandraza , Ravaoarimanga Masiarivony , Raobela Oméga , Razafimaharo Lala Yvette , Ralemary Nicolas , Andrianasolomanana Mahefa , Pontarollo Julie , Mukerabirori Aline , Ochieng Walter , Dentinger Catherine M. , Kapesa Laurent , Steinhardt Laura C. 
Published: June 2024

Abstract
Background
Global progress on malaria control has stalled recently, partly due to challenges in universal access to malaria diagnosis and treatment. Community health workers (CHWs) can play a key role in improving access to malaria care for children under 5 years (CU5), but national policies rarely permit them to treat older individuals. We conducted a two-arm cluster randomized trial in rural Madagascar to assess the impact of expanding malaria community case management (mCCM) to all ages on health care access and use.

Methods
Thirty health centers and their associated CHWs in Farafangana District were randomized 1:1 to mCCM for all ages (intervention) or mCCM for CU5 only (control). Both arms were supported with CHW trainings on malaria case management, community sensitization on free malaria care, monthly supervision of CHWs, and reinforcement of the malaria supply chain. Cross-sectional household surveys in approximately 1600 households were conducted at baseline (Nov–Dec 2019) and endline (Nov–Dec 2021). Monthly data were collected from health center and CHW registers for 36 months (2019–2021). Intervention impact was assessed via difference-in-differences analyses for survey data and interrupted time-series analyses for health system data.

Results
Rates of care-seeking for fever and malaria diagnosis nearly tripled in both arms (from less than 25% to over 60%), driven mostly by increases in CHW care. Age-expanded mCCM yielded additional improvements for individuals over 5 years in the intervention arm (rate ratio for RDTs done in 6–13-year-olds, RRRDT6–13 years = 1.65; 95% CIs 1.45–1.87), but increases were significant only in health system data analyses. Age-expanded mCCM was associated with larger increases for populations living further from health centers (RRRDT6–13 years = 1.21 per km; 95% CIs 1.19–1.23).

Conclusions
Expanding mCCM to all ages can improve universal access to malaria diagnosis and treatment. In addition, strengthening supply chain systems can achieve significant improvements even in the absence of age-expanded mCCM.

Trial registration
The trial was registered at the Pan-African Clinical Trials Registry (#PACTR202001907367187).
Optimizing perioperative treatment for potentially resectable stage III squamous cell lung carcinoma: promising results of a condensed four-cycle regimen with tislelizumaband chemotherapy
Authors: Shan Jianzhen , Liu Zhen , Chen Songan , Du Chengli , Li Bing , Ruan Lingxiang , Kong Mei , Wang Lingjie , Du Miaoyan , Shi Shuo , Qiao Guoliang , Tian Tian , Tu Zhengliang 
Published: June 2024

Abstract
Background
The standard care for resectable non-small cell lung cancer (NSCLC) involves perioperative therapy combining chemotherapy and immune checkpoint inhibitors, typically lasting 6 to 12 months. However, the optimal treatment strategies for potentially resectable squamous cell lung carcinoma (SCC) remain unclear. This Phase 2 trial aimed to assess the efficacy and safety of a condensed four-cycle perioperative treatment regimen with tislelizumab combined with chemotherapy in patients with potentially resectable stage III SCC.

Methods
Patients with potentially resectable stage IIIA-IIIB (N2) SCC received intravenous tislelizumab, albumin-bound paclitaxel, and carboplatin for up to four cycles. The primary endpoints were major pathologic response (MPR) and incidence of treatment-related adverse events. Safety and potential biomarkers for efficacy prediction were also assessed.

Results
Among 35 enrolled patients, 32 underwent surgery with R0 resection achieved in all cases. MPR was achieved in 24 patients and pathological complete response (pCR) in 14 patients. Radiographic objective response was observed in 31 patients. The 12-month and 24-month event-free survival rate was 85.7 and 61.0%, respectively. Four patients experienced grade 3 or 4 adverse events. Tumor tissue based next-generation sequencing revealed the potential associations between several biomarkers and pathological response, including tumor neoantigen burden score, 18-gene expression profile score, CD8 + T cells, M1/M2 macrophages ratio and interferon‐gamma expression level. Besides, circulating tumor DNA (ctDNA) dynamics and concentration were also associated with pathological response and the presence of ctDNA at postoperative month 1 was a strong predictor for disease relapse. Furthermore, metagenomic sequencing in bronchoalveolar lavage fluid demonstrated Streptococcus was the most abundant genus in the pCR group.

Conclusions
A condensed four-cycle perioperative treatment regimen of tislelizumab combined with chemotherapy demonstrated promising efficacy and manageable toxicities in potentially resectable stage III SCC. Specific biomarkers showed potential for predicting treatment efficacy and the mechanism of superior antitumor response of pCR patients was preliminarily and indirectly explored.

Trial registration
ClinicalTrials.gov, NCT05024266. Registered August 27, 2021.