bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract P195: Metabolites Mediate the Association of the MIND Diet With Hypertension and Chronic Kidney Disease
Authors: Couch Catharine , Ament Zsuzsanna , Patki Amit , Kijpaisalratana Naruchorn , Bhave Varun M , Jones Alana , Armstrong Nicole D , Kimberly W. Taylor , Irvin Ryan M 
Published: May 2024

The Mediterranean-DASH diet intervention for neurodegenerative delay (MIND), is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. The Mediterranean and DASH diets are associated with decreased risk of cardiometabolic disease; however, less is known regarding the association of the MIND diet with cardiometabolic disease. The objectives of this analysis were (1) to determine if the MIND diet is associated with prevalent hypertension and chronic kidney disease (CKD) and (2) to identify metabolites associated with the MIND diet and if these metabolites mediate the association of the MIND diet with hypertension and CKD.
In the REasons for Geographic and Racial Disparities in Stroke (REGARDS) cohort, we examined the association of the MIND diet with prevalent hypertension and CKD. Fully adjusted models included age, sex, race, calories, alcohol, smoking, education, exercise, income, region, BMI, lipidemia, history of coronary artery disease, and diabetes. In the REGARDS stroke case-cohort sub-study, 357 metabolites were measured in baseline plasma. Weighted linear regression models were used to test the association between MIND diet score and metabolites adjusting for age, sex, race, calories, alcohol, and smoking. Weighted logistic regression models were used to test the association between MIND-metabolites and hypertension and CKD adjusting for age, race, sex, BMI, alcohol, and smoking. Mediation analysis was conducted to examine metabolites mediating the association between MIND diet and hypertension and CKD. Sensitivity analyses were conducted in the cohort random controls.
A higher MIND diet score was associated with lower odds of hypertension (odds ratio [OR] 0.97, 95% CI 0.96-0.99; p=0.01) and CKD (OR 0.88, 95% CI 0.86-0.91; p<0.0001). Fifty-one metabolites were associated with the MIND diet (MIND-metabolites). Three MIND-metabolites were associated with greater odds of hypertension; however, these associations were attenuated in the fully adjusted models. Twelve MIND-metabolites were associated with greater odds of CKD. Mediation analyses indicated dimethylguanidino valeric acid (DMGV), guanosine, and C7 carnitine to mediate the association between MIND diet and hypertension. DMGV, guanosine, gluconic acid, S-Adenosyl-L-homocysteine, C7 carnitine, and 5 triacylglycerols mediated the association between MIND diet and CKD. Higher adherence to the MIND diet is associated with a lower likelihood of hypertension and CKD. MIND diet-related metabolites were found to be associated with hypertension and CKD and may provide insight to metabolic pathways linking diet and disease.
Machine Learning Differentiates Extracorporeal Membrane Oxygenation Mortality Risk Profiles Among Trauma Patients
Authors: Campbell Bryan R. , Rooney Alexandra S. , Krzyzaniak Andrea , Calvo Richard Y. , Checchi Kyle D. , Carroll Alyssa N. , Sise Michael J. , Bansal Vishal , Krzyzaniak Michael J. 
Published: May 2024

Background Extracorporeal membrane oxygenation (ECMO) is resource intensive with high mortality. Identifying trauma patients most likely to derive a survival benefit remains elusive despite current ECMO guidelines. Our objective was to identify unique patient risk profiles using the largest database of trauma patients available. Methods ECMO patients ≥16 years were identified using Trauma Quality Improvement Program data (2010-2019). Machine learning K-median clustering (ML) utilized 101 variables including injury severity, demographics, comorbidities, and hospital stay information to generate unique patient risk profiles. Mortality and patient and center characteristics were evaluated across profiles. Results A total of 1037 patients were included with 33% overall mortality, mean age 32 years, and median ISS = 26. The ML identified 3 unique patient risk profile groups. Although mortality rates were equivalent across the 3 groups, groups were distinguished by (Group 1) young (median 25 years), severely injured (ISS = 34) patients with thoracic and head injuries (99%) via blunt mechanism (93%), and a high prevalence of ARDS (77%); (Group 2) relatively young (median 30 years) and moderately injured (ISS = 22) patients with exposure-related injuries (11%); and (Group 3) older (median 46 years) patients with a high proportion of comorbidities (69%) and extremity injuries (100%). There were no differences based on center ECMO volume, teaching status, or ACS-Level across all 3 groups. Conclusion Machine learning compliments traditional analyses by identifying unique mortality risk profiles for trauma patients receiving ECMO. These details can further inform treatment guidelines, clinical decision making, and institutional criteria for ECMO usage.
Effects of Trauma Cue Exposure and Posttraumatic Stress Disorder (PTSD) on Affect and Cannabis Craving in Cannabis Users With Trauma Histories: Use of Expressive Writing as an Online Cue-Reactivity Paradigm: Effets de l'exposition aux signaux traumatiques et du SSPT sur l'affect et le besoin de cannabis chez les consommateurs de cannabis ayant des antécédents de traumatismes : utilisation de l'écriture expressive comme paradigme de réactivité en ligne
Authors: DeGrace Sarah , Barrett Sean P. , Yakovenko Igor , Tibbo Philip G. , Romero-Sanchiz Pablo , Carleton R. Nicholas , Snooks Thomas , Rudnick Abraham , Stewart Sherry H. 
Published: May 2024

Objectives Posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) commonly co-occur. Conditioned associations between psychological trauma cues, distress, cannabis use, and desired relief outcomes may contribute to the comorbidity. These conditioned associations can be studied experimentally by manipulating trauma cue exposure in a cue-reactivity paradigm (CRP) and examining effects on affective and cognitive outcomes in participants with and without PTSD. However, traditional CRPs take place in-lab limiting recruitment/power. We aimed to examine the effects of CRP condition (trauma and neutral) and PTSD group (likely PTSD+ and PTSD−) on affective and craving outcomes using a stand-alone online expressive writing CRP. Methods Participants ( n = 202; 43.6% male; Mage = 42.94 years, SD = 14.71) with psychological trauma histories and past-month cannabis use completed a measure of PTSD symptoms (PTSD Checklist-5 for DSM-5 [PCL-5]) and were randomized to complete either a trauma or neutral expressive writing task. Then they completed validated measures of affect (Positive and Negative Affect Schedule-Short Form [PANAS-SF]) and cannabis craving (Marijuana Craving Questionnaire-Short Form [MCQ-SF]). Results Linear mixed models tested the hypothesized main and interactive effects of CRP condition (trauma and neutral) and PTSD group (likely PTSD+ and PTSD−) on negative and positive affect (PANAS-SF) and cannabis craving dimensions (MCQ-SF). The hypothesized main effects of trauma versus neutral expressive writing were found for negative affect and the expectancy dimension of cannabis craving and of PTSD group for negative affect and all cannabis craving dimensions; no interactions were observed. Conclusions Expressive writing appears a useful online CRP. Interventions focused on reducing negative affect and expectancy craving to trauma cues may prevent/treat CUD among cannabis users with PTSD. Plain Language Summary Title The Use of an Online Expressive Writing as a Trauma Cue Exposure: Effects on Craving and Emotions
Prevalence and Predictors of Anxiety and Depression in Indian Patients with  Type 2 Diabetes
Authors: Tripathi Pramod , Sharma Baby , Kadam Nidhi , Biswas Mayurika Das , Tiwari Diptika , Vyawahare Anagha , Kathrikolly Thejas , Kuppusamy Maheshkumar , Vijayakumar Venugopal 
Published: May 2024

Background: Numerous investigations indicate the presence of a reciprocal association between type 2 diabetes (T2D) and a range of mental health conditions. However, research on the factors that contribute to depression and anxiety in T2D patients in India is scarce. Purpose: The present study aims to identify the prevalence and predictors of depression and anxiety in patients with T2D in India. Methods: A cross-sectional study that included 2,730 patients with T2D was conducted at the Freedom from Diabetes Clinic in Pune, India. Anxiety and depression were measured by the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7) Scale. Binary logistic regression was applied to identify the factors predicting anxiety and depression. Results: The prevalence of depression and anxiety were 20.3% and 17.3%, respectively. The major predictors of anxiety and depression were female gender, obesity, unmarried marital status, poor glycaemic control and the presence of comorbid conditions. Conclusion: This study’s findings highlight a significant prevalence of depression and anxiety among patients with T2D in India, with key predictors including gender, obesity, marital status, glycaemic control and comorbid conditions. These findings highlight the critical need for integrated mental health support in routine diabetes care to manage depression and anxiety.
Improving explanation of motor disability with diffusion-based graph metrics at onset of the first demyelinating event
Authors: Foster Michael A , Prados Ferran , Collorone Sara , Kanber Baris , Cawley Niamh , Davagnanam Indran , Yiannakas Marios C , Ogunbowale Lola , Burke Ailbhe , Barkhof Frederik , Wheeler-Kingshott Claudia AM Gandini , Ciccarelli Olga , Brownlee Wallace , Toosy Ahmed T 
Published: May 2024

Background: Conventional magnetic resonance imaging (MRI) does not account for all disability in multiple sclerosis. Objective: The objective was to assess the ability of graph metrics from diffusion-based structural connectomes to explain motor function beyond conventional MRI in early demyelinating clinically isolated syndrome (CIS). Methods: A total of 73 people with CIS underwent conventional MRI, diffusion-weighted imaging and clinical assessment within 3 months from onset. A total of 28 healthy controls underwent MRI. Structural connectomes were produced. Differences between patients and controls were explored; clinical associations were assessed in patients. Linear regression models were compared to establish relevance of graph metrics over conventional MRI. Results: Local efficiency ( p = 0.045), clustering ( p = 0.034) and transitivity ( p = 0.036) were reduced in patients. Higher assortativity was associated with higher Expanded Disability Status Scale (EDSS) (β = 74.9, p = 0.026) scores. Faster timed 25-foot walk (T25FW) was associated with higher assortativity (β = 5.39, p = 0.026), local efficiency (β = 27.1, p = 0.041) and clustering (β = 36.1, p = 0.032) and lower small-worldness (β = −3.27, p = 0.015). Adding graph metrics to conventional MRI improved EDSS ( p = 0.045, Δ R2 = 4) and T25FW ( p < 0.001, Δ R2 = 13.6) prediction. Conclusion: Graph metrics are relevant early in demyelination. They show differences between patients and controls and have relationships with clinical outcomes. Segregation (local efficiency, clustering, transitivity) was particularly relevant. Combining graph metrics with conventional MRI better explained disability.
Diverting ostomy prior to neoadjuvant treatment in rectal cancer should be used selectively: A retrospective single-center cohort study
Authors: Valdimarsson Valentinus , Munshi Eihab , Lydrup Marie-Louise , Jutesten Henrik , Samuelsson Carolina , Buchwald Pamela 
Published: May 2024

Background: Rectal cancer patients commonly benefit from neoadjuvant therapy before resection surgery. For these patients, an elective ostomy diversion is frequently considered, despite the absence of conclusive evidence when a diversion is advantageous. This is a retrospective observational single-center study on a 4-year consecutive rectal cancer cohort undergoing neoadjuvant therapy, aiming at improving the understanding of risks and benefits associated with ostomy diversion. Material and Method: Baseline characteristics, tumor-specific data, clinical events, and outcomes were collected using the Swedish Colorectal Cancer Registry and medical records. Results: Thirty-two (30.2%) of the 106 included patients presented with endoscopic impassable tumors at diagnosis, of which 18 (56.2%) had diverting ostomy. Three out of 14 with impassable tumor and no diversion developed a bowel obstruction. None of the patients with an endoscopically passable tumor at diagnosis (n = 74) experienced a bowel obstruction. The elective diversions (n = 40) were not associated with serious complications (Clavien–Dindo grade ⩾ 3b). Patients with a diverting ostomy (n = 30) had similar time intervals from diagnosis to neoadjuvant treatment and to definite tumor resection as those without diversion but experienced more complex primary tumor resections in terms of blood loss and operation time. Conclusion: An elective diverting ostomy is a relatively safe procedure in rectal cancer patients requiring neoadjuvant therapy. More than one out of five non-diverted patients with endoscopically impassable rectal tumors developed bowel obstruction and would potentially have benefited from an elective diversion.
CircAGFG1 Promotes Ovarian Cancer Progression Through the miR-409-3 p/ZEB1 Axis
Authors: Luo Jie , Zhong Hua , Guo Mei , Xiao Peihong , Cao Rongyu , Zhao Mandan , Jing Yongping 
Published: May 2024

Objectives Circular RNAs (circRNAs) serve a crucial regulatory role in ovarian cancer (OC). Circular RNA ArfGAP with FG repeats 1 (circAGFG1) has been shown to be involved in promoting the progression of several cancers, containing triple-negative breast cancer, esophageal cancer and colorectal cancer. However, the function of circAGFG1 in OC is unclear. Methods Quantitative real-time reverse transcription PCR (RT-qPCR) was conducted to determine the expression levels of circAGFG1 and miR-409-3p. The proliferation and metastasis of cells were determined by colony formation assays, EdU assays, transwell assays and wound healing assays. In addition, a dual-luciferase reporter assay was performed to validate the mechanism between circAGFG1, miR-409-3p, and ZEB1. Results Our data suggested that circAGFG1 was significantly overexpressed in OC tissues compared to normal ovarian epithelial tissues. Overexpression of circAGFG1 was correlated with intraperitoneal metastasis, tumor recurrence and advanced stage. Additionally, circAGFG1 overexpression revealed a poor prognosis in OC patients. Knockdown of circAGFG1 suppressed the proliferation, invasion and migration of OC cells. Mechanistically, circAGFG1 acted as a sponge of miR-409-3p to enhance the expression level of zinc finger E-box binding homeobox 1 (ZEB1), thereby conferring OC cell proliferation, invasion and migration. Importantly, re-expression of ZEB1 effectively reversed the effects of circAGFG1 knockdown on OC cells. Conclusions In summary, our study indicated that circAGFG1 may act as a prognostic biomarker and potential therapeutic target for patients with OC.
Athlete monitoring perspectives of sports coaches and support staff: A scoping review
Authors: Timmerman Wouter P. , Abbiss Chris R. , Lawler Nathan G. , Stanley Mandy , Raynor Annette J. 
Published: May 2024

Objectives To map and summarise the sports coaches’ and support staff's perspectives on athlete monitoring to explore the breadth of literature, identify knowledge gaps and inform future research. Design Scoping review based on the Joanna Briggs Institute (JBI) methodology. Methods SPORTDiscus, MEDLINE, APA PsycInfo, and Embase databases were searched in English until 6 September 2022. The inclusion criteria were (1) coach(es) and/or support staff were explicitly questioned about their knowledge, perceptions, understanding, opinions, and/or applied practice of athlete monitoring; (2) results could be directly attributed to coach(es) and/or support staff; (3) primary research projects that are available as full-text. Exclusion criteria were applied for grey literature. The data were extracted into a custom-made data charting spreadsheet. Results From the 4381 identified records, 42 met the eligibility criteria. Almost all the studies were conducted within the Anglosphere and at the national or international level. The main reasons for coaches and support staff to implement athlete monitoring were to reduce injury and illness, inform the training program, and improve or maintain performance. While training load monitoring is generally seen as valuable the coaches and support staff acknowledged that there was no perfect scientific approach to monitoring athletes and believed it should be part of the bigger picture, emphasising communication. Conclusions There has been a recent surge in research demonstrating that athlete monitoring extends beyond quantitative information and encompasses non-quantified subjective information. This further substantiates that coaches and support staff will remain central to athlete monitoring, even amidst the anticipated technological progress.
Cross-border telework and the applicable labour law: The role of different connecting factors in determining objectively applicable law
Authors: Rosin Annika 
Published: May 2024

In the case of cross-border employment, the applicable law is determined mainly according to habitual place of work. If this factor cannot be clarified, the engaging place of business of the employer determines the applicable law. Both factors can be set aside if the relationship is more closely connected to some other country. Telework is performed outside the employers’ premises, and the determination of the exact workplace can be difficult. This again complicates the determination of the applicable law in cross-border cases. This article analyses how, in the case of cross-border telework, the applicable law should be determined. It is argued that the exact system depends on the type of telework. If telework is performed in one country abroad, the habitual place of work determines the applicable law. If teleworker has at least two offices or manages his own working time, the second connecting factor applies. As the determination of the applicable law according to the engaging place of business is not considered to be sufficiently employee-protective, escape clause should be emphasised in the second case to guarantee the best employment protection to the employee.
Heated tobacco products- well known or well understood? A national cross-sectional study on knowledge, attitudes and usage in Pakistan
Authors: Irshad Hammad Atif , Jehanzeb Hamzah , Raja Sajjan , Saleem Umair , Shaikh Wamiq Ali , Shahzad Akmal , Amirali Atiqa , Iqbal Nousheen , Khan Javaid Ahmed 
Published: May 2024

Abstract
Background
Heated tobacco products (HTPs) are reshaping the tobacco industry and just recently, a plan was sought to regularize HTPs in Pakistan. Pakistan provides an intriguing case study in this context, as tobacco use is deeply ingrained in public use. To ensure that future evidence-based policy recommendations are grounded in the public’s knowledge, attitudes, and usage of HTPs, a nationwide survey must be conducted.

Methods
A cross-sectional study was conducted using an online-based questionnaire nationwide in Pakistan. The questionnaire was validated and distributed through convenience sampling. The questionnaire assessed participants’ knowledge, attitudes, and usage of HTPs. Descriptive statistics was used to describe participants’ response and linear regression was performed at a p-value of < 0.05 using SPSS version 26.

Results
In our sample of 1195 respondents (mean age of 33 years, 41.8% males and 58.2% females), 54.7% had previously heard about HTPs and 16.9% reported using HTPs at least once. Additionally, 38.24% were unsure of the legality of HTP use. Those with monthly household incomes of PKR 100,000 to 500,000, were more likely to have higher knowledge scores (OR:1.80[1.07–3.04]). On the other hand, males (OR:0.70 [0.55–0.89]) and respondents from Balochistan (OR:0.40 [0.22–0.71]) were more likely to have lower knowledge scores. The strongest motivators were the enjoyability of HTPs (55.73%) and usage as a cigarette alternative (54.64%), while the strongest deterrents were the negative health effects (82.68%) and potential for addiction (81.01%).

Conclusion
Our study underscores the need for awareness campaigns and interventions concerning HTPs, given prevalent preconceived notions and mixed attitudes among respondents. It was found that women and households with higher incomes scored higher on knowledge. Subjective enjoyment and a substitute for cigarettes were important motivators, but the most mentioned deterrents were the possibility of addiction and the detrimental effects on health. These insights form the basis for informed policy making for non-cigarette tobacco products.
Factors associated with clinical nurse’s mental health: a qualitative study applying the social ecological model
Authors: Yu Qiang , Huang Chongmei , Tian Yusheng , Yang Jiaxin , Li Xuting , Ning Meng , Chen Zengyu , Du Jie , He Jiaqing , Li Yamin 
Published: May 2024

Abstract
Background
The prevalence of burnout, depression, and anxiety among Chinese nurses was 34%, 55.5%, and 41.8% respectively. Mental health problems have significant impacts on their personal well-being, work performance, patient care quality, and the overall healthcare system. Mental health is influenced by factors at multiple levels and their interactions.

Methods
This was a descriptive qualitative study using phenomenological approach. We recruited a total of 48 nurses from a tertiary hospital in Changsha, Hunan Province, China. Data were collected through focus group interviews. Audio-recorded data were transcribed and inductively analysed.

Results
Four major themes with 13 subthemes were identified according to the social ecological model: (1) individual-level factors, including personality traits, sleep quality, workplace adaptability, and years of work experience; (2) interpersonal-level factors, encompassing interpersonal support and role conflict; (3) organization-level factors, such as organizational climate, organizational support, career plateau, and job control; and (4) social-level factors, which included compensation packages, social status, and legislative provision and policy.

Conclusions
Our study provides a nuanced understanding of the multifaceted factors influencing nurses’ mental health. Recognizing the interconnectedness of individual, interpersonal, organizational, and social elements is essential for developing targeted interventions and comprehensive strategies to promote and safeguard the mental well-being of nurses in clinical settings.

Trial and protocol registration
The larger study was registered with Chinese Clinical Trial Registry: ChiCTR2300072142 (05/06/2023) https://www.chictr.org.cn/showproj.html?proj=192676.

Reporting method
This study is reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ).