bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges in the management of operable triple-negative breast cancer in a survivor of the B-cell acute lymphoblastic leukemia: a case report
Authors: Pavlin Tina , Blatnik Ana , Šeruga Boštjan 
Published: May 2024

BackgroundOperable triple-negative breast cancer (TNBC) is an unfavorable subtype of breast cancer, which usually requires an aggressive perioperative systemic treatment. When TNBC presents as a second primary cancer after cured acute leukemia, its management might be challenging.Case presentationWe present a case report of a young postmenopausal woman with an operable TNBC who had a history of the B-cell acute lymphoblastic leukemia (B-ALL) and graft versus host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT). A history of previous treatment with anthracyclines and radiotherapy and GVHD limited the use of doxorubicin for treatment of her TNBC. Due to the history of GVHD, perioperative treatment with pembrolizumab was omitted. Genetic testing was challenging due to the possible contamination of her tissues with the donor’s cells after allo-SCT. In samples of our patient’s buccal swab, peripheral blood, and tumor tissue, a pathogenic variant in the partner and localizer of BRCA2 (PALB2) gene was found. With neoadjuvant chemotherapy which included carboplatin, a pathologic complete response was achieved. Although our patient has a low risk for recurrence of TNBC, her risk for the development of new primary cancers remains substantial.ConclusionThis case highlights challenges in the systemic treatment, genetic testing, and follow-up of patients with operable TNBC and other solid cancers who have a history of acute leukemia.
High-intensity interval training in patients with glaucoma (HIT-GLAUCOMA): protocol for a multicenter randomized controlled exercise trial
Authors: Van Eijgen Jan , Schuhmann Valentin , Fingerroos Emma-Liina , Renier Marie , Burchert Holger , Kröpfl Julia Maria , Van Craenenbroeck Amaryllis , Cornelissen Véronique , Gugleta Konstantin , Stalmans Ingeborg , Hanssen Henner 
Published: May 2024

BackgroundGlaucoma stands as a prominent global cause of irreversible blindness and the primary treatment approach involves reducing intraocular pressure (IOP). However, around one-third of patients exhibit disease progression despite effective IOP reduction. Microvascular endothelial function, chronic inflammation, and oxidative stress are known to affect retinal neuronal networks and have been associated with disease severity and progression. Exercise training has the potential to counteract these mechanisms as add-on treatment to usual care.AimsThe HIT-GLAUCOMA study will investigate the effects of a 6-month high-intensity interval training (HIIT) on intermediate endpoints such as local retinal microvascular and systemic large artery function, inflammation, and oxidative stress as well as clinical endpoints such as visual field indices, optic nerve rim assessment, retinal nerve fiber layer thickness, IOP, number of eye drops, vision-related quality of life and ocular surface disease symptomatology.MethodsThe study is a multi-center randomized controlled clinical trial in patients with both normal tension and high-tension primary open angle glaucoma. Across two study centers, 128 patients will be enrolled and randomized on a 1:1 basis into an exercise intervention group and a usual care control group. The primary microvascular endpoints are retinal arteriolar and venular flicker light-induced dilation at 6 months. The primary endpoint in the systemic circulation is brachial artery flow-mediated dilation at 6 months.Anticipated resultsWe hypothesize that exercise therapy will improve retinal microvascular function and thus ocular blood flow in patients with glaucoma. As clinical outcomes, we will investigate the effect of exercise on visual field indices, optic nerve rim assessment, retinal nerve fiber layer thickness, IOP, number of eye drops, vision-related quality of life and ocular surface disease symptomatology.DiscussionHIT-GLAUCOMA is a blueprint trial design to study the effect of exercise training on neurodegenerative and cardiovascular diseases. Importantly, patients are also expected to benefit from improvements in general health and cardiovascular co-morbidities. If proven effective, exercise may offer a new add-on treatment strategy to slow glaucoma progression.Clinical Trial Registration NumberThe trial is registered at Clinicaltrials.gov under the identifier NCT06058598 and is currently in the recruitment stage.
A combined intervention strategy to increase linkage to and retention in substance use treatment for individuals accessing hospital-based services: study protocol
Authors: Crisanti A. S. , Page K. , Saavedra J. L. , Kincaid T. , Caswell C. M. , Waldorf V. A. 
Published: May 2024

BackgroundIn 2020, New Mexico had the highest alcohol related death and the 11th highest drug overdose rate in the U.S. Towards the long-term goal of addressing this public health problem, we are implementing and evaluating an multi-level intervention designed to identify adults at risk of substance use disorder (SUD) and encourage linkage to and retention in treatment. The first level includes equipping the ED and medical inpatient units of a safety-net hospital with a method to screen individuals at risk of a SUD. The second level includes Seeking Safety (SS), a trauma-specific treatment for PTSD and SUD; and pharmacotherapy for SUD. Motivational Interviewing (MI) is used throughout both levels. Using the SPIRIT guidelines and checklist, this study protocol describes the multi-level intervention and the methodology we are using to assess feasibility and effectiveness.MethodsWe are using a Type 1 hybrid implementation design with a non-randomized approach (ISRCTN registration # ISRCTN33100750). We aim to enroll 110 adults (≧18) who screen positive for unhealthy use of alcohol, prescription medications (used nonmedically) and/or illicit drugs. Peer support workers are responsible for screening, using MI to increase engagement in screening and treatment and delivery of SS. Pharmacotherapy is provided by addiction clinical specialists. Treatment is provided post hospital discharge via telehealth to increase access to care. Participants are identified through (1) review of electronic health records for individuals with a chief or secondary complaint or mental health condition relating to alcohol and/or other drug use, (2) referrals from clinical staff and (3) screening in the ED and medical inpatient units. Feasibility is being measured through process data. Effectiveness will be determined by changes in two primary outcomes: (i) PTSD symptom severity; and (ii) substance use.DiscussionOur study will expand on research related to the implementation of treatment strategies for patients presenting at EDs and admitted to medical inpatients units wherein there is a significant window of opportunity to link patients with follow-up behavioral and clinical services for alcohol and/or drug misuse. The challenges associated with implementation and strategies that have been helpful to address these challenges will further inform the field.
Exome functional risk score and brain connectivity can predict social adaptability outcome of children with autism spectrum disorder in 4 years’ follow up
Authors: Luo Tingting , Zhang Manxue , Li Sixun , Situ Mingjing , Liu Pei , Wang Meiwen , Tao Yujie , Zhao Shengnan , Wang Zhuo , Yang Yanping , Huang Yi 
Published: May 2024

IntroductionAutism Spectrum Disorder (ASD) is a common neurodevelopmental disorder emerging in early childhood, with heterogeneous clinical outcomes across individuals. This study aims to recognize neuroimaging genetic factors associated with outcomes of ASD after a 4-year follow-up.MethodsA total of 104 ASD children were included in this study; they underwent clinical assessments, MRI data acquisition, and the whole exome sequencing (WES). Exome functional risk score (EFRS) was calculated based on WES; and two modalities of brain connectivity were constructed based on MRI data, that is functional connectivity (FC) for functional MRI (fMRI), and individual differential structural covariance network (IDSCN) for structural MRI (sMRI), to explore the neuroimaging genetic biomarker of outcomes of ASD children.ResultsRegression analysis found EFRS predicts social adaptability at the 4-year follow-up (Y = -0.013X + 9.29, p = 0.003). We identified 19 pairs of FC associated with autism symptoms severity at follow-up, 10 pairs of FC and 4 pairs of IDSCN associated with social adaptability at follow-up, and 10 pairs of FC associated with ASD EFRS by support vector regression (SVR). Related brain regions with prognostic predictive effects are mainly distributed in superior frontal gyrus, occipital cortex, temporal cortex, parietal cortex, paracentral lobule, pallidum, and amygdala for FC, and temporal cortex, thalamus, and hippocampus for IDSCN. Mediation model showed that ASD EFRS affects the social communication of ASD children through the mediation of FC between left middle occipital gyrus and left pallidum (RMSEA=0.126, CMIN=80.66, DF=42, p&lt; 0.001, CFI=0.867, AIC=152). DiscussionOur findings underscore that both EFRS and brain connectivity can predict social adaptability, and that brain connectivity serving as mediator in the relationship of EFRS and behaviors of ASD, suggesting the intervention targets in the future clinical application.
The role of arts therapies in mitigating Sleep Initiation and Maintenance Disorders: a systematic review
Authors: Luo Xuexing , Zhang Aijia , Li Hong , Li Yu , Ying Fangtian , Wang Xiaoli , Yang Qianxu , Zhang Zheyu , Huang Guanghui 
Published: May 2024

IntroductionArts therapies offer effective non-pharmacological intervention for Sleep Initiation and Maintenance Disorders (SIMDs), encompassing both passive and active modalities. This review assesses their effectiveness and ethical considerations, focusing on music therapy, meditation, and Tai Chi.MethodsFollowing PRISMA guidelines, a detailed search across PubMed, the Cochrane Library, Web of Science, and CNKI identified 17 relevant RCTs. Utilizing the Joanna Briggs Institute (JBI) quality criteria and the PICO(S) framework for data extraction ensured methodological integrity.ResultsAnalysis shows arts therapies significantly improve sleep quality. Music therapy and meditation yield immediate benefits, while Tai Chi and Qigong require longer commitment for significant outcomes. DiscussionThe link between SIMDs and mental health issues like anxiety, stress, and depression suggests arts therapies not only enhance sleep quality but also address underlying mental health conditions. The evidence supports a wider adoption of arts therapies in treating SIMDs due to their dual benefits.Systematic review registrationPROSPERO, ID: CRD42024506393.
Efficacy of clozapine versus standard treatment in adult individuals with intellectual disability and treatment-resistant psychosis (CLOZAID): study protocol of a multicenter randomized clinical trial
Authors: Alemany-Navarro María , Sánchez-Barbero Bianca , Reguera-Pozuelo Pablo , Altea-Manzano Laura , Gómez-Garrido Ana , Rocha-González Idalino , Garrido-Torres Nathalia , Ruiz-Veguilla Miguel , García-Cerro Susana , Rosso-Fernández Clara M. , Villagrán-Moreno José María , Sarramea Fernando , Cervilla-Ballesteros Jorge , Martínez-Leal Rafael , Mayoral-Cleries Fermín ,   CLOZ-AID Group, Crespo-Facorro Benedicto 
Published: May 2024

BackgroundIntellectual disability (ID) affects approximately 1% of the worldwide population and individuals with ID have a higher comorbidity with mental illness, and specifically psychotic disorders. Unfortunately, among individuals with ID, limited research has been conducted since ID individuals are usually excluded from mental illness epidemiological studies and clinical trials. Here we perform a clinical trial to investigate the effectiveness of clozapine in the treatment of resistant psychosis in individuals with ID. The article highlights the complexity of diagnosing and treating psychopathological alterations associated with ID and advocates for more rigorous research in this field.MethodsA Phase IIB, open-label, randomized, multicenter clinical trial (NCT04529226) is currently ongoing to assess the efficacy of oral clozapine in individuals diagnosed with ID and suffering from treatment-resistant psychosis. We aim to recruit one-hundred and fourteen individuals (N=114) with ID and resistant psychosis, who will be randomized to TAU (treatment as usual) and treatment-with-clozapine conditions. As secondary outcomes, changes in other clinical scales (PANSS and SANS) and the improvement in functionality, assessed through changes in the Euro-QoL-5D-5L were assessed. The main outcome variables will be analyzed using generalized linear mixed models (GLMM), assessing the effects of status variable (TAU vs. Clozapine), time, and the interaction between them.DiscussionThe treatment of resistant psychosis among ID individuals must be directed by empirically supported research. CLOZAID clinical trial may provide relevant information about clinical guidelines to optimally treat adults with ID and treatment-resistant psychosis and the benefits and risks of an early use of clozapine in this underrepresented population in clinical trials.Trial registrationClinicaltrials.gov: NCT04529226. EudraCT: 2020-000091-37.
The role of grid management in community risk governance: a case study in Yuelu, China
Authors: Gao Shan , Liu Wenhui 
Published: May 2024

ObjectiveIn this study, we aim to provide a comprehensive analysis of the effectiveness of the risk prevention and control mechanism within the grid management model for community risk prevention. We emphasize the importance of thoroughly examining the risk prevention and control mechanism to enhance risk management efforts in urban communities, particularly in response to unforeseen outbreaks such as COVID-19.MethodsCase studies are widely acknowledged as one of the most effective approaches to examine governance in China. In this study, the “Yuelu Model” serves as an illustrative example to demonstrate the application and effectiveness of grid management in community risk governance. To ensure the validity of the case study, it is imperative to adhere to the principle of representativeness. The collection of case data involves a combination of primary and secondary sources, and supplementary information is obtained through follow-up investigations conducted via WeChat, telephone, and other means, thereby enhancing the comprehensiveness and accuracy of the data.ResultsOur analysis reveals significant findings regarding the impact of the grid management model, fulfilling a triple role as a “Social Safety Valve” in the management process: (1) Community stress reduction function, (2) Community alarm function, and (3) Community integration function. Furthermore, we explore the adaptability of the grid management mechanism in addressing community risks, highlighting its effectiveness and potential for broader application.DiscussionThe findings of this study suggest that: Firstly, it is crucial to establish a shared information repository among different departments on a big data platform. Secondly, a dynamic government public information internal network should be established through collaborative efforts among multiple departments. Thirdly, implementing a regular (or periodic) early warning mechanism is essential. Lastly, the establishment of a high-quality talent team for power grid management is highly recommended. Our research provides valuable insights to enhance community risk governance.
Tendency of microbial adhesion to denture base resins: a systematic review
Authors: Alqarawi Firas K. , Gad Mohammed M. 
Published: May 2024

ObjectivesDigital denture fabrication became an alternative method to conventional denture fabrication. However reviewing the antimicrobial performance of newly introduced digital fabrication methods in comparison to the conventional method is neglected. Aim of study: this review was to compare the antiadherence properties of various CAD-CAM subtractive (milled), additive (3D printed) conventional denture base resins. In order to answer the developed PICO question: “Does CAD-CAM milled and 3D printed denture base resins have microbiological antiadherence properties over the conventional ones?” We included comparative studies on digitally fabricated Denture base resins with conventionally fabricated one in term of microbial adhesion.MethodsAll in vitro studies investigated the microbial adherence to CAD-CAM milled and 3D printed denture base resins in comparison to conventional were searched in the PubMed, Web of Sciences, and Scopus databases up to December 2023.ResultsFifteen studies have been investigated the microbial adhesion to milled and 3D printed denture base resins. CAD-CAM milled resins significantly decreased the microbial adhesion when compared with the conventional resins and 3D printed resins, while the later showed a high tendency for microbial adhesion. The addition of antifungal agents to 3D printed resins significantly reduced C. albicans adhesion. In terms of 3D printing parameters, printing orientation affected adherence while printing technology had no effect on microbial adhesion.ConclusionDenture base materials and fabrication methods significantly affect the microbial adhesion. CAD-CAM milled denture base resins demonstrated low microbial adhesion. 3D-printed resins showed high tendency for C. albicans adhesion. The antiadherent properties of 3D-printed resins can be improved by incorporating antifungal agents or changing the printing parameters, but further investigations are required to validate these modifications.
Impact of rearing systems in the Eastern Amazon on cholesterol, β-carotene and vitamin E homologues in steer
Authors: dos Santos Miranda Lobato Adriny , da Silva Jamile Andrea Rodrigues , de Carvalho Rodrigues Thomaz Cyro Guimarães , Silva André Guimarães Maciel e , da Cruz Andrea Viana , Ferreira Ana Paula Damasceno , Costa Mónica Mendes , Cunha Antonio Marcos Quadros , Lourenço-Costa Vanessa Vieira , Barbosa Antônio Vinícius Corrêa , Prates José António Mestre , de Brito Lourenço-Júnior José 
Published: May 2024

IntroductionThe quality of meat, with a focus on compounds important for human health, is directly related to the rearing systems in which the animals are produced. The search for a balanced diet, with an emphasis on low cholesterol and adequate levels of vitamins, aligns with society’s emphasis on healthy eating, directly correlated with the importance of the offer made by producers for the cattle’s diet.Objective and methodologyThe objective was to verify the impact of different rearing systems, in the Eastern Amazon, during the rainy season, on the concentrations of vitamins (A, E) and cholesterol in the muscle (Longissimus lumborum) of crossbred Nelore cattle, castrated, aged between 24 and 36 months, and weighing between 410 and 628 kg. Twelve animals, from each of the three pasture rearing systems: native pasture in flooded areas of Monte Alegre; native pasture in a flooded area of Santa Cruz do Arari; and pasture cultivated on dry land in São Miguel do Guamá, all located in Pará, Brazil—were sampled in commercial slaughterhouses.ResultsA notable influence was observed in the concentrations of β-carotene (p &lt; 0.01), α-Tocopherol (p = 0.02), β-Tocopherol (p &lt; 0.01) and the combined sum of β-Tocotrienol and γ-Tocopherol (p &lt; 0.01), as well as δ-Tocopherol (p &lt; 0.01) when contrasting extensive with intensive systems (confinement). However, there was a difference in the content of vitamins and cholesterol between the isolated extensive systems, or between the four rearing systems (p &gt; 0.05). Extensive systems, mainly in Monte Alegre, demonstrated greater amounts of α-Tocopherol and δ-Tocopherol.ConclusionOn the other hand, the intensive system exhibited higher levels of other investigated compounds, clarifying the nutritional variations generated by different livestock rearing practices in the region. Therefore, the results obtained are innovative in the Eastern Amazon, Brazil, in addition to inspiring the development of new research to meet other demands in this field, and achieve additional results, such as determining which meat, coming from cattle in production systems in the country, presents the better compositional quality of vitamins and lipids.
PENGARUH TERAPI DOA KRISTIANI TERHADAP SKOR KECEMASAN PASIEN PRE OPERASI
Authors: Hardiansyah Safitri Kiki , Pabontong Yethi Octovin 
Published: May 2024

Latar Belakang: Operasi adalah tindakan dengan resiko komplikasi dan cidera yang dapat menimbulkan kematian, menjadi ketakutan yang menyebabkan kecemasan. Terapi doa dilakukan untuk mengelola kecemasan untuk mengurangi resiko gagal dilakukan operasi karena efek dari kecemasan pasien. Tujuan: menganalisis pengaruh terapi doa kristiani terhadap tingkat kecemasan pasien pre operasi di RSUD Malinau. Metodologi: studi Quasi Eksperimen pada 31 pasien pre operasi non cancer yang beragama Kristen Protestan dengan kesadaran penuh, yang berada di rawat inap satu hari hingga satu jam menjelang operasi. Teknik pengambilan concecutve sampling, dengan pemberian terapi doa selama 15 menit sebelum operasi.Kusioner yang digunakan adalah Amsterdam Preoperative Anxiety And Information Scale (APAIS).Hasil: Pasien yang terlibat dalam penelitian ini sebagian besar responden adalah lansia akhir dengan usia 56 -65 tahun dengan persentase 29,0%.Pasien Laki-laki berjumlah 67,7% dan pendidikan terbanyak SMA 38.7 %, dengan status menikah 71,0%, pekerjaan yang paling banyak adalah petani yaitu 29% dan jenis operasi yang terbanyak adalah digestif 45,2%. Nilai kecemasan sebelum pemberian intervensi terapi doa adalah 12,94 % dan setelah intervensi terapi 9,87%.Analisis T-Test didapatkan p value 0,000.Kesimpulan: Terdapat perbedaan signifikan secara statistik kecemasan sebelum dan sesudah terapi doa.Terapi doa dapat membantu pasien dalam mengelola kecemasan sebelum pre operasi. Saran: Terapi doa dapat dilanjutkan dalam standar prosedur sebelum operasi bagi pasien yang beragama Kristen Protestan
HUBUNGAN SIKAP DAN DUKUNGAN KELUARGA DENGAN TINGKAT KEKAMBUHAN PASIEN SKIZOFRENIA DI PUSKESMAS WILAYAH PERKOTAAN KABUPATEN BERAU
Authors: Ain Annisa , Yunita Nina 
Published: May 2024

Latar Belakang: Skizofrenia merupakan gangguan jiwa psikotik yang dapat menimbulkan resiko ke kambuhan sepanjang kehidupan pasien. Salah satu faktor penyebab terjadinya kekambuhan tersebut adalah kurangnya peran serta keluarga dalam perawatan pasien. Tujuan : menganalisa hubungan antara sikap dan dukungan keluarga terhadap tingkat kekambuhan pasien jiwa dengan diagnosa skizofrenia. Metode: Penelitian ini merupakan penelitian deskriptif Analitik dengan pendekatan cross sectional. Tekhnik sampling melibatkan 50 responden yang di kumpulkan dengan teknik Purposive sampling. data dikumpulkan dengan menggunakan kuesioner dan di analisis menggunakan uji fisher exact dan chi square. Hasil: Analisa data menunjukkan responden memiliki sikap baik sebesar 32 responden 64%, dan dukungan Keluarga Baik sebesar 29 responden (58%), dan kambuh berulang sebesar 24 responden 48%. hasil uji fisher exact Untuk variabel sikap dengan kekambuhan Menunjukkan Nilai p Value 0.042 Sedangkan uji Chi-Square dukungan keluarga dengan kekambuhan nilai p value 0,011 kurang α 0.05. Kesimpulan: Sehingga terdapat hubungan yang signifikan antara sikap dan dukungan keluarga terhadap tingkat kekambuhan pasien jiwa dengan diagnosa skizofrenia di Puskesmas Wilayah Perkotaan Kabupaten Berau. Jadi keluarga harus meningkatkan kesadaran dan pemahaman keluarga dalam menyikapi dan mendukung pasien jiwa dengan diagnosa skizofrenia dengan cara mendukung secara emosional, informasi, instrumental serta penilaian.