bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Validation of a Nomogram for Predicting Survival Based on Ferritin and Transferrin Ratio in Breast Cancer Patients
Authors: Huang Shuqing , Lai Hao , Pan Xiaolan , Lin Qiumei , Qin Yuling , Liu Fengfei , Fang Min , Huang Wencheng , Wei Caibiao 
Published: June 2024

Background Our objective is to develop a predictive model utilizing the ferritin and transferrin ratio (FTR) and clinical factors to forecast overall survival (OS) in breast cancer (BC) patients. Methods We conducted a retrospective analysis of clinical data from 2858 BC patients diagnosed between 2013 and 2021. Subsequently, the cohort of 2858 BC patients underwent random assignment into distinct subsets: a training cohort comprising 2002 patients and a validation cohort comprising 856 patients, maintaining a proportional ratio of 7:3. Employing multivariable Cox regression analysis within the training cohort, we derived a prognostic nomogram. The predictive performance was assessed using calibration curves, C-index, and decision curve analysis. Results The final prognostic model included the TNM stage, subtype, hemoglobin levels, and the ferritin-transferrin ratio. The nomogram achieved a C-index of .794 (95% CI: .777-.810). The nomogram demonstrated superior predictive accuracy for OS at 3, 5, and 7 years for BC, with area under the time-dependent curves of .812, .782, and .773, respectively. These values notably outperformed those of the conventional TNM stage. Decision curve analysis reaffirmed the greater net benefit of our nomogram compared to the TNM stage. These findings were subsequently validated in the independent validation cohort. Conclusion The FTR-based prognostic model may predict a patient’s OS better than the TNM stage in a clinical setting. The nomogram can provide an early, affordable, and reliable tool for survival prediction, as well as aid clinicians in treatment option-making and prognosis evaluation. However, further multi-center prospective trials are required to confirm the reliability of the existing nomogram.
Change in Nutrition Behavior After Participating in an Obesity-Related Cancer Education Program in El Paso, Texas.
Authors: Miller Mary , Valenzuela Roy , Salinas Jennifer J. 
Published: June 2024

Background Roughly 25% of the U.S- Border city, El Paso, Texas is obese. Obesity is a major risk factor for 13 cancers. Cancer is the leading cause of death in El Paso. Therefore, there is a growing urgency to implement evidence-based programs that support behavioral change that helps curb the impact of obesity in El Paso and the U.S.-Mexico border region. Purpose This study aimed to assess the effectiveness of an obesity-related cancer prevention program (Pasos Para Prevenir Cancer (PPPC) on changes in participant nutrition behaviors. Methods Culturally tailored, theory-based education was provided to adults through the PPPC program. A total of 256 PPPC participants agreed to take part in our program evaluation. Participants were asked to complete a survey at baseline and 6 months after they completed the program. Session included topics on obesity-related cancers, assessing your obesity risk, measuring body fat, SMART goal setting, and how to find the right type of physical activity. For this report we used the Food Frequency Questionnaire (FFQ) data to assess changes between baseline and six months. We also used perceived dietary barriers as moderators on the relationship between program participation and nutrition behaviors. Results Most participants (92.2%) identified as being of Mexican American descent, were between the ages of 41-75 years of age (n = 165) and identified as females (n = 225). 48.1% of the participants were born in Mexico while 50.4% were born in the U.S. Approximately 35-51% of participants improved and sustained their intake of healthier foods at 6 month follow up. Specifically, there was a statistically significant shift from higher fat and sugar content foods to light and low-fat foods, and fruits and vegetables. Participants also increased their consumption of ground chicken, lean red meat, and seafood. A key modifier in this relationship is perceived health risk. Conclusion Latinos on the U.S.-Mexico border ascribe to a healthy living mindset. In general, they frequently eat fruits and vegetables. Participation in PPPC increased perceived barriers to healthy living around cost and convenience and enhanced decision-making around healthier options. Participants responded to our adapted evidence-based program resulting in sustained changes in nutrition behaviors. Using adapted evidence-based strategies developed outside of the U.S.-Mexico border region is a feasible approach to address persist health disparities.
An interpretative phenomenological analysis of the psychosexual identity development in adolescent and young adult survivors of testicular cancer
Authors: Aldiwan Abdullah , McParland James , Leeuwerik Tamara , Stoneham Sara , Williamson Max , Christie Deborah 
Published: June 2024

Background Qualitative research has explored how some testicular cancer survivors (TCS) experience the psychological impacts of diagnosis and treatment. More research into the impacts of testicular cancer (TC) on adolescent and young adults (AYA) is needed due to the critical period of identity development. The present study aimed to explore how AYA with TC appraise and make sense of their experience and to develop a greater understanding of psychosexual identity development in AYA TCS. Method Eight AYA TCS were interviewed. The results were analysed using Interpretative Phenomenological Analysis. The questions explored the experiences relating to diagnosis and treatment, how it affected their psychosexual identity development (e.g., sexual relationships and self-image) and the meanings attached to the experiences. Analysis Four Group Experiential Themes were developed from the data; ‘Dealing with the shock’, ‘Fear and weight of responsibility’, ‘those closest to me’ and ‘sense of change’. Discussion The AYA TCS experiences may result in adoption of traditional masculine traits (e.g., stoicism) or abandonment of traditionally masculine traits (E.g. violence and aggression). AYA TCS also described feelings of insecurity when compared to other men. Psychology input could help manage stoicism and feelings of inferiority when compared to men with two testicles.
Autistic adults’ perspectives and experiences of diagnostic assessments that include play across the lifespan
Authors: Pritchard-Rowe Emma , de Lemos Carmen , Howard Katie , Gibson Jenny 
Published: June 2024

Play is often included in autism diagnostic assessments. These tend to focus on ‘deficits’ and non-autistic interpretation of observable behaviours. In contrast, a neurodiversity-affirmative assessment approach involves centring autistic perspectives and focusing on strengths, differences and needs. Accordingly, this study was designed to focus on autistic perspectives of diagnostic assessments that incorporate play. Autism community stakeholders were consulted on the design of the study. Semi-structured interviews were conducted with 22 autistic adults aged 18–57 years who live in the United Kingdom. Interpretative phenomenological analysis was used to identify themes. Autistic adults highlighted the varying ways in which play was included in their diagnostic assessments, such as via the Autism Diagnostic Observation Schedule. Our findings highlight the importance of better adapting assessment to the heterogeneity of autism. For example, our findings question the extent to which play is useful for assessing autistic women and girls who mask. Our findings also suggest that holistic, neurodiversity-affirmative assessment practices should be adopted. Our findings support the importance of adopting a personalised approach to diagnostic assessments that use play, in addition to assessing strengths and differences as well as needs. Lay abstract Play is often included in autism diagnostic assessments. These assessments tend to focus on negatives and how people who are not autistic interpret observable behaviours. It is important to take a neurodiversity-affirmative assessment approach. This involves focusing on what autistic people say and looking at strengths and needs. We wanted to find out how autistic adults experience diagnostic assessments that include play. We asked autistic and non-autistic people to help us design our study and interview questions. We then interviewed 22 autistic adults to find out what they think about the use of play in assessments. We used a qualitative method called interpretative phenomenological analysis to analyse the data. Autistic adults told us about the different ways play was included in their diagnostic assessments. For example, some completed a diagnostic tool called the Autism Diagnostic Observation Schedule. Autistic adults also talked about the importance of considering how autistic people are different to each other. For example, we found that play may not be useful for assessing women or girls who mask. This suggests that professionals should adopt a personalised approach to diagnostic assessments that use play catering to each person’s needs. Our findings also suggested that professionals should assess strengths and differences as well as needs.
Meta-analysis of etrolizumab versus placebo in ulcerative colitis: safety and efficacy outcomes
Authors: Zhang Rui , Jia Ziran , Piao Yingshi 
Published: June 2024

Background: The existing body of scientific literature offers inconclusive findings on the safety and therapeutic effectiveness of etrolizumab (ETR) for the treatment of ulcerative colitis (UC). Objectives: The goal of this meta-analysis is to furnish a comprehensive synthesis of evidence that evaluates the safety and therapeutic effects of ETR in the management of UC. Design: Meta-analysis. Data sources and methods: PubMed, Embase, and Web of science were searched to collect relevant English studies, and the reference lists of eligible studies were manually searched to avoid missing any eligible studies. Outcome measures encompassed clinical response, incidence of adverse events, histological remission, endoscopic remission, endoscopic improvement, and antidrug antibodies. Relevant data were extracted by two independent investigators. Results: The meta-analysis incorporated five eligible studies, involving a total of 1528 patients, with 1015 treated with ETR and 513 with placebo. The pooled analysis indicates that ETR is both effective and safe. The adverse event rates, endoscopic and histological response, as well as overall remission were comparable between the two groups. The monoclonal antibody group had a lower incidence rate of adverse reactions than the placebo group [odds ratio (OR): 0.81; 95% confidence interval (CI): 0.63–1.03; p = 0.09)]. Clinical response was higher in the ETR group than in the placebo group (OR: 1.56; 95% CI: 1.20–2.02; p = 0.0009), and endoscopic improvement was more favorable in the ETR group (OR: 1.88; 95% CI: 1.45–2,45; p < 0.00001). A higher rate of endoscopic remission was found in the ETR group than in the placebo group (OR: 2.48; 95% CI: 1.75–3.50; p < 0.00001); histological remission was significantly higher in the ETR group than in the placebo group (OR: 2.11; 95% CI: 1.55–2.86; p < 0.00001). The placebo group had a lower rate of positive antidrug antibodies (OR: 1.31; 95% CI: 0.79–2.17; p < 0.29), and the incidence of complications was significantly higher in the ETR group compared with the placebo group (OR: 2.05; 95% CI: 1.48–2.83; p < 0.0001). Conclusion: Given the heterogeneity and potential biases in the included studies, gastroenterologists should cautiously tailor drug delivery strategies based on their clinical experience and the unique needs of individual patients. PROSPERO registration: CRD42023396100
Supporting patients with a mental health diagnosis to use online services in primary care. A qualitative interview study
Authors: Parsons Jo , Abel Gary , Bryce Carol , Campbell John , Newbould Jennifer , Pitchforth Emma , Stockwell Stephanie , Treadgold Bethan , Winder Rachel , Atherton Helen 
Published: June 2024

Objective The increase in reliance on online services for general practice has the potential to increase inequalities within some populations. Patients with a mental health condition are one such group. Digital facilitation is defined as a range of processes, procedures, and people, which seek to support NHS patients in using online services. This study aimed to examine the views and experiences of digital facilitation in primary care amongst patients living with a mental health condition. Methods Semi-structured interviews were conducted with patients living with a mental health condition, recruited from general practices across England participating in the Di-Facto study. Thematic analysis was conducted on interview transcripts. Results Interviews were conducted with ten participants with a mental health condition, recruited from five general practices. Three themes were identified: (1) familiarity with online services; (2) experiences of those using online services; (3) the need for digital facilitation. The need for digital facilitation was identified in the registration for online services, and in trusting online services. Conclusions Online services offer convenience for patients, but registration for the use of such services remains a potential area of difficulty. Participants had difficulties with registering for online services and had concerns about trust in using them. Support offered by general practices in using online services needs to be varied and adaptable to meet the needs of individual patients.
A control system model of capability-opportunity-motivation and behaviour (COM-B) framework for sedentary and physical activity behaviours
Authors: Daryabeygi-Khotbehsara Reza , Dunstan David W. , Shariful Islam Sheikh Mohammed , Rhodes Ryan E. , Hojjatinia Sahar , Abdelrazek Mohamed , Hekler Eric , Markides Brittany , Maddison Ralph 
Published: June 2024

Objective Theoretical frameworks are essential for understanding behaviour change, yet their current use is inadequate to capture the complexity of human behaviour such as physical activity. Real-time and big data analytics can assist in the development of more testable and dynamic models of current theories. To transform current behavioural theories into more dynamic models, it is recommended that researchers adopt principles such as control systems engineering. In this article, we aim to describe a control system model of capability-opportunity-motivation and behaviour (COM-B) framework for reducing sedentary behaviour (SB) and increasing physical activity (PA) in adults. Methods The COM-B model is explained in terms of control systems. Examples of effective behaviour change techniques (BCTs) (e.g. goal setting, problem-solving and social support) for reducing SB and increasing PA were mapped to the COM-B model for illustration. Result A fluid analogy of the COM-B system is presented. Conclusions The proposed integrated model will enable empirical testing of individual behaviour change components (i.e. BCTs) and contribute to the optimisation of digital behaviour change interventions.
Digitally managing depression: A fully remote randomised attention-placebo controlled trial
Authors: Kandola Aaron , Edwards Kyra , Muller Marie AE , Dührkoop Bettina , Hein Bettina , Straatman Joris , Hayes Joseph F 
Published: June 2024

Background Depression is a common and disabling condition. Digital apps may augment or facilitate care, particularly in under-served populations. We tested the efficacy of juli, a digital self-management app for depression in a fully remote randomised controlled trial. Methods A pragmatic randomised controlled trial that included participants aged > 18 who self-identified as having depression and scored > 5 on the Patient Health Questionnaire-8. Participants were randomly assigned (1:1) to receive juli for 8 weeks or a limited attention-placebo control app. Our primary outcome was the difference in Patient Health Questionnaire-8 scores at 8 weeks. Secondary outcomes were remission, minimal clinically important difference, worsening of depression, and health-related quality of life. Analyses were per-protocol (primary), and modified and full intention-to-treat (secondary). The trial was registered at ISRCTN (ISRCTN12329547). Results Between May 2021 and January 2023, we randomised 908 participants. 662 completed the week 2 outcome assessment and were included in the modified intention-to-treat analysis, and 456 completed the week 8 outcome assessments (per-protocol). In the per-protocol analysis, the juli group had a greater reduction in Patient Health Questionnaire-8 score (10.78, standard deviation 6.26) than the control group (11.88, standard deviation 5.73) by week 8 (baseline adjusted β-coefficient −0.94, 95% CI: −1.87 to −0.22, p = 0.045). Achieving remission and a minimal clinically important difference was more likely in the juli group at 8 weeks (adjusted odds ratios 2.22, 95% CI: 1.45–3.39, p < 0.001 and 1.56, 95% CI: 1.08–2.27, p = 0.018, respectively). There were no between-group differences in health-related quality of life or worsening of depression. Modified and full intention-to-treat analyses found similar results, but the primary outcome was non-significant. Conclusion The use of juli for 8 weeks resulted in a small reduction in symptoms of depression compared with an attention-placebo control. The juli app is a digital self-management tool that could increase the accessibility of evidence-based depression treatments.
The role of interleukin-10 receptor alpha (IL10Rα) in Mycobacterium avium subsp. paratuberculosis infection of a mammary epithelial cell line
Authors: Fong Aisha , Rochus Christina M. , Shandilya Umesh K. , Muniz Maria M.M. , Sharma Ankita , Schenkel Flavio S. , Karrow Niel A. , Baes Christine F. 
Published: June 2024

Abstract
Background
Johne’s disease is a chronic wasting disease caused by the bacterium Mycobacterium avium subspecies paratuberculosis (MAP). Johne’s disease is highly contagious and MAP infection in dairy cattle can eventually lead to death. With no available treatment for Johne’s disease, genetic selection and improvements in management practices could help reduce its prevalence. In a previous study, the gene coding interleukin-10 receptor subunit alpha (IL10Rα) was associated with Johne’s disease in dairy cattle. Our objective was to determine how IL10Rα affects the pathogenesis of MAP by examining the effect of a live MAP challenge on a mammary epithelial cell line (MAC-T) that had IL10Rα knocked out using CRISPR/cas9. The wild type and the IL10Rα knockout MAC-T cell lines were exposed to live MAP bacteria for 72 h. Thereafter, mRNA was extracted from infected and uninfected cells. Differentially expressed genes were compared between the wild type and the IL10Rα knockout cell lines. Gene ontology was performed based on the differentially expressed genes to determine which biological pathways were involved.

Results
Immune system processes pathways were targeted to determine the effect of IL10Rα on the response to MAP infection. There was a difference in immune response between the wild type and IL10Rα knockout MAC-T cell lines, and less difference in immune response between infected and not infected IL10Rα knockout MAC-T cells, indicating IL10Rα plays an important role in the progression of MAP infection. Additionally, these comparisons allowed us to identify other genes involved in inflammation-mediated chemokine and cytokine signalling, interleukin signalling and toll-like receptor pathways.

Conclusions
Identifying differentially expressed genes in wild type and ILR10α knockout MAC-T cells infected with live MAP bacteria provided further evidence that IL10Rα contributes to mounting an immune response to MAP infection and allowed us to identify additional potential candidate genes involved in this process. We found there was a complex immune response during MAP infection that is controlled by many genes.
Gut resistome linked to sexual preference and HIV infection
Authors: Rubio Garcia Elisa , Casadellà Maria , Parera Mariona , Vila Jordi , Paredes Roger , Noguera-Julian Marc 
Published: June 2024

Abstract
Background
People living with HIV (PLWH) are at increased risk of acquisition of multidrug resistant organisms due to higher rates of predisposing factors. The gut microbiome is the main reservoir of the collection of antimicrobial resistance determinants known as the gut resistome. In PLWH, changes in gut microbiome have been linked to immune activation and HIV-1 associated complications. Specifically, gut dysbiosis defined by low microbial gene richness has been linked to low Nadir CD4 + T-cell counts. Additionally, sexual preference has been shown to strongly influence gut microbiome composition in PLWH resulting in different Prevotella or Bacteroides enriched enterotypes, in MSM (men-who-have–sex-with-men) or no-MSM, respectively. To date, little is known about gut resistome composition in PLWH due to the scarcity of studies using shotgun metagenomics. The present study aimed to detect associations between different microbiome features linked to HIV-1 infection and gut resistome composition.

Results
Using shotgun metagenomics we characterized the gut resistome composition of 129 HIV-1 infected subjects showing different HIV clinical profiles and 27 HIV-1 negative controls from a cross-sectional observational study conducted in Barcelona, Spain. Most no-MSM showed a Bacteroides-enriched enterotype and low microbial gene richness microbiomes. We did not identify differences in resistome diversity and composition according to HIV-1 infection or immune status. However, gut resistome was more diverse in MSM group, Prevotella-enriched enterotype and gut micorbiomes with high microbial gene richness compared to no-MSM group, Bacteroides-enriched enterotype and gut microbiomes with low microbial gene richness. Additionally, gut resistome beta-diversity was different according to the defined groups and we identified a set of differentially abundant antimicrobial resistance determinants based on the established categories.

Conclusions
Our findings reveal a significant correlation between gut resistome composition and various host variables commonly associated with gut microbiome, including microbiome enterotype, microbial gene richness, and sexual preference. These host variables have been previously linked to immune activation and lower Nadir CD4 + T-Cell counts, which are prognostic factors of HIV-related comorbidities. This study provides new insights into the relationship between antibiotic resistance and clinical characteristics of PLWH.
Application of a new designed high resolution melting analysis for mycobacterial species identification
Authors: Khosravi Azar Dokht , Meghdadi Hossein , Hashemzadeh Mohammad , Alami Ameneh , Tabandeh Mohammad Reza 
Published: June 2024

AbstractThe Non-tuberculous mycobacterial (NTM) isolates should be distinguished from tuberculosis and identified at the species level for choosing an appropriate treatment plan. In this study, two molecular methods were used to differentiate NTM species, including a new designed High Resolution Melting (HRM) and Multilocus Sequence Analysis (MLSA). Seventy-five mycobacterial isolates were evaluated by sequencing four genes ( MLSA) and a HRM assay specifically targeting atpE was designed to rapidly and accurately identify and differentiate mycobacterium species. Out of 70 NTM isolates, 66 (94.3%), 65 (92.9%), 65 (92.9%) and 64 (91.4%) isolates were identified to the species level by PCR of atpE, tuf, rpoB and dnaK genes. We could identify 100% of the isolates to the species level (14 different species) by MLSA. By using HRM assay, all NTM isolates were identified and classified into eight groups, in addition, Mycobacterium tuberculosis and Nocardia were also detected simultaneously. The MLSA technique was able to differentiate all 14 species of NTM isolates. According to the results, the HRM assay is a rapid and beneficial method for identifying NTM, M. tuberculosis (MTB), and Nocardia isolates without sequencing.