bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges Faced by Nurses in Transitioning Pediatric Sickle Cell Disease Patients to Adult Care
Authors: Amoaku Gifty Enyonam , Wuaku Delali Adwoa , Senoo-Dogbey Vivian Efua 
Published: February 2025

Background Sickle-cell disease is a common genetic red blood cell disorder with global concern. Sub-Saharan Africa, including Ghana, is most predominantly affected. Improvement in medicine has enhanced children's survival into adulthood; hence the need to transition them into adult care services. Well-transitioned patients manage the condition without undue disruptions in their quality of life. Aim To explore the challenges faced by nurses in transitioning pediatric patients to adult care. Method The study adopted a phenomenological descriptive qualitative design to describe and interpret the difficulties nurses encounter when providing transition care to adolescent patients. Purposive sampling and convenience sampling methods were used to select 15 professional nurses from the pediatric department. Thematic content analysis was used to analyze the data. The interview transcripts were read to identify emerging themes and sub-themes and exported into Nvivo 12 software. Results Nurses working at the pediatric department of the regional health facility had no education on how to transition children from pediatric to adult care, leading to poor evidence-based transition care. In addition, there was a lack of transitional care protocol, staff training, care collaboration, transition planning, follow-up initiatives to track and monitor progress, difficulty in tracking the transition process, increased workload, and transition resource constraints. Conclusion Nurses at the regional health facility have inadequate education on transitional care of adolescent patients, in-service training and workshop on transitional care on the management of patients, and formulating a policy on transitional care to guide nurses at the pediatric unit.
Associations of oxidative balance score and cognition in US older adults: A cross-sectional study of National Health and Nutrition Examination Survey (NHANES) 2011 to 2014
Authors: Jin Yue , Lin Huajian , Ye Zegen , Wang Huaqiang , Liu Yangkun , Qiu Weiwen , Liu Chunhua 
Published: February 2025

Background Oxidative stress is linked to cognitive decline in the elderly. Diet, as a key energy source, affects brain function and serves as a modifiable risk factor for cognitive decline. Objective This study investigates the relationship between the Oxidative Balance Score (OBS), which reflects diet and lifestyle impact on oxidative stress, and cognitive function in older adults. Methods This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2011–2014, including 2716 participants aged 60 and older. Cognitive outcomes measured were the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word Learning test, Animal Fluency test, and Digit Symbol Substitution test. Linear regression models were used to assess the relationship between the OBS and cognitive performance, with stratification and sensitivity analyses conducted to explore these associations further. Results Among 2716 participants, higher dietary OBS scores were linked to better cognitive test performance after adjusting for confounders. For example, the highest OBS quartile had a 4.35-point increase in CERAD immediate recall compared to the lowest quartile (OR: 4.35, 95% CI: 2.14–8.84, p = 0.001). Subgroup analyses showed this positive association across age groups and genders, though it was stronger among non-Hispanic white participants compared to other racial groups. Conclusions Our findings indicate a positive correlation between OBS and cognitive function in older adults, suggesting that an antioxidant-rich diet and lifestyle may help prevent cognitive decline in this population. However, since this study is cross-sectional, further prospective research is needed to confirm these results.
Spatio-temporal distribution of COVID-19 cases and tuberculosis in four provinces of Sumatra Islands, Indonesia
Authors: Saputra Arif , Wichaidit Wit , Kesuma Zurnila Marli , Chongsuvivatwong Virasakdi 
Published: February 2025

Abstract

Background
The COVID-19 pandemic disrupted national tuberculosis programs in high-burden countries. We hypothesize that COVID-19 occurrence had a delayed effect on tuberculosis case reports from the Indonesia Ministry of Health, also known as the tuberculosis case notification. The objectives of this study are: (1) to describe the potential effect of the reported COVID-19 cases on the spatial distribution of tuberculosis in four provinces of Sumatra Islands (Aceh, North Sumatra, West Sumatra, and Riau Provinces), Indonesia; (2) to estimate the temporal lag effect of the occurrence of COVID-19 on tuberculosis case notifications.

Methods
We retrieved data from the Indonesian Ministry of Health and the Indonesia COVID-19 Task Force. We also examined the monthly tuberculosis and COVID-19 case notifications. We identified time series clusters of tuberculosis case notifications and used lag non-linear model to assess the delayed effect of the occurrence of COVID-19 cases on tuberculosis case notifications.

Results
The secondary data included 217,593 tuberculosis case notifications (January 2019 to December 2022) and 373,671 reported COVID-19 cases (January 2020 to December 2022). Time series cluster analysis revealed 5 clusters each for monthly tuberculosis case notifications and monthly reported COVID-19 cases. There was a negative association with a 0-month lag in more than 10,000 reported COVID-19 cases (RR = 0.95, 95%CI: 0.91–0.98).

Conclusions
The findings suggested that Indonesia’s national tuberculosis program in four provinces of Sumatra Island was disrupted during the COVID-19 pandemic. Lag analysis showed that COVID-19 case occurrence had an immediate effect on tuberculosis case notifications.

Clinical trial
Not applicable.
Assistive technologies in healthcare: utilization and healthcare workers perceptions in Germany
Authors: Sommer Domenic , Lermer Eva , Wahl Florian , Lopera G. Luis I. 
Published: February 2025

Abstract

Background
According to the WHO, assistive technology (AT) is defined as the superset of technologies that improve or maintain the functioning of different senses, mobility, self-care, well-being, and inclusion of patients. ATs also include technologies for healthcare workers (HCWs) to reduce workloads and improve efficiency and patient care outcomes. Software ATs for HCWs include communication software, artificial intelligence (AI), text editors, planning tools, decision support systems, and health records. Hardware ATs for HCWs can range from communication devices, sensors, and specialized medical equipment to robots.

Aims
With this indicative study, we explore HCW utilization, perceptions, and adoption barriers of ATs. We emphasize ATs role in enhancing HCWs’ efficiency and effectiveness in healthcare delivery.

Methods
A cross-sectional online survey was conducted through August 2024 with HCWs in Bavaria via a network recruiting approach. We used convenience sampling but ensured that only HCWs were part of our study population. Our survey included (i) usage, (ii) usefulness, and (iii) perceptions regarding ATs. The survey comprised 11 close-ended and three open-ended questions, including story stems evaluated by a deductive qualitative template analysis. Our mixed-method evaluation also employed descriptive and bivariate statistics.

Results
Three hundred seventy-one HCWs (♂63.9 %, ♀36.1 %) participated in our survey, primarily 133 administrators, 116 nurses, and 34 doctors. More than half of the study participants (58.6 %) reported having advanced technical skills. Regarding usage, communication platforms (82.2 %) and communication devices (86 %) were the most commonly used ATs. Advanced ATs such as body-worn sensors, medical devices with interfaces, identification devices, and robots were underutilized in our sample. ATs were reported to be helpful in all job roles but need improvements in capacity and integration. Key barriers to adoption included outdated infrastructure, interoperability, and a lack of training.

Conclusion
Our study suggests that HCWs may want to incorporate ATs into their workflows as they see how, in theory, these technologies would improve HCW’s efficiency, resulting in better patient care. However, to realize this potential, efforts in ATs integration and accessibility are essential. Given this study’s modest sample size and generalizability limitations, further research is needed to explore the adoption, implementation, and impact of ATs in healthcare.
The development of emotional overeating: a longitudinal twin study from toddlerhood to early adolescence
Authors: Madhavan Vaishnavi K. , Nas Zeynep , Blissett Jacqueline , Llewellyn Clare , Herle Moritz 
Published: February 2025

Abstract

Background
Previous research has estimated the genetic and environmental contribution to individual differences in emotional overeating in toddlerhood and early childhood. However, little is known how this behaviour tracks into adolescence. Here, we aimed to replicated previous work and examine the aetiology of stability and change in emotional overeating across time.

Methods
Data were from the UK Gemini Twin Study, which includes 2402 twin pairs born in 2007. Parents reported on children’s emotional overeating at 16 months (n = 3784), 5 years (n = 2064), and 12 years (n = 964), using the Emotional Overeating Scale of the Child Eating Behaviour Questionnaire (CEBQ) at 5 and 12 years, and the CEBQ-T (toddler version) at 16 months. A Cholesky Decomposition twin model was used to quantify the additive genetic, shared, and nonshared environmental influences on emotional overeating at each time point, partitioned into aetiological effects unique to each age and those carried across time.

Results
Additive genetic effects were minimal at 16 months and 5 years (9% and 7% respectively) but increased to 34% by 12 years. Shared environmental effects explained the majority of variance in emotional overeating at all three time points, but significantly less at 12 years (41%) than earlier (> 81%). The longitudinal phenotypic associations (r = 0.23–0.43) were explained by the shared environment.

Conclusion
The shared environment plays a major role in the development of emotional overeating in early life. Most aetiological influences on emotional overeating were unique to each age, indicating the need for family-based interventions targeted to each developmental stage.
A phase 2 randomized, double-blind trial of ART-001, a selective PI3Kα inhibitor, for the treatment of slow-flow vascular malformations
Authors: Ozeki Michio , Tanaka Akira , Kuniyeda Kanako , Nozaki Taiki , Fujino Akihiro , Nomura Tadashi , Uemura Naoto , Suenobu Souichi , Aramaki-Hattori Noriko , Hayashi Ayato , Kato Aiko , Kiyosue Hiro , Imagawa Kotaro , Nagao Munetomo , Shimizu Fumiaki , Ochi Junko , Horiuchi Saya , Ohyama Tetsuji , Ando Haruhi , Nagabukuro Hiroshi 
Published: February 2025

Abstract

Background
In patients with slow-flow vascular malformations (SFVMs) including venous malformations (VM), lymphatic malformations (LM) or Klippel–Trenaunay Syndrome (KTS), somatic gain-of-function mutations in genes encoding phosphatidyl inositol 3-kinase alpha (PI3Kα, gene name PIK3CA) have been identified. A phase 2 study was conducted with the patients to assess the efficacy and safety of ART-001 (serabelisib), an orally available selective PI3Kα inhibitor.

Methods
This is a multicenter, randomized, double-blind, proof-of-concept, phase 2 trial. Eligible participants were patients aged 2 years and older, diagnosed either with VM, LM or KTS. Participants were administered either 50 or 100 mg of ART-001 for 24 weeks. The primary endpoint was the response rate defined as the proportion of participants who achieved ≥ 20% reduction in lesion volume at week 24. Secondary endpoints include safety, pharmacokinetics, pain, and quality of life scores.

Results
Thirty-five patients (median age: 14 years old; VM, n = 17, KTS, n = 13 and LM, n = 5) were randomly assigned and received treatment (50 mg, n = 17 and 100 mg, n = 18). ART-001 showed a response rate: 29.4% (95% confidence interval 10.3–56.0%) at 50 mg and 33.3% (13.3–59.0%) at 100 mg. Mean lesion volume reductions at 50 mg and 100 mg were − 2.3% (95% CI − 14.3 to 9.6%) and − 12.6% (− 25.3 to 0.06%), respectively. No drug-related serious adverse events were observed. Treatment-emergent adverse events were generally mild to moderate and transient. Pharmacokinetic profiles were similar between pediatric and adolescent/adult patients except for lower Ctrough levels in pediatric patients.

Conclusion
ART-001 was effective and well-tolerated in patients with SFVMs. These results support the further development of ART-001 in SFVMs and other PIK3CA-related overgrowth syndromes to confirm clinical benefits and long-term safety.

Trial registration: Japan Registry of Clinical Trial, jRCT2071210027. Registered May 25 2021,https://jrct.niph.go.jp/en-latest-detail/jRCT2071210027
Evaluating the efficacy of vatiquinone in preclinical models of Leigh syndrome and GPX4 deficiency
Authors: Kayser Ernst-Bernhard , Mulholland Michael , Olkhova Elizaveta A. , Chen Yihan , Coulson Holly , Cairns Owen , Truong Vivian , James Katerina , Johnson Brittany M. , Hanaford Allison , Johnson Simon C. 
Published: February 2025

Abstract

Background
Genetic mitochondrial diseases are a major challenge in modern medicine. These impact ~ 1:4,000 individuals and there are currently no effective therapies. Leigh syndrome is the most common pediatric presentation of mitochondrial disease. In humans, patients are often treated with antioxidants, vitamins, and strategies targeting energetics. The vitamin-E related compound vatiquinone (EPI-743, α-tocotrienol quinone) has been the subject of at least 19 clinical trials in the US since 2012, but the effects of vatiquinone on an animal model of mitochondrial disease have not yet been reported. Here, assessed the impact of vatiquinone in cellular assays and animal models of mitochondrial disease.

Methods
The efficacy of vatiquinone in vitro was assessed using human fibroblasts and HEK293 cells treated with the ferroptosis inducers RSL3 and BSO + Fe(III)Citrate, the mitochondrial oxidative stress inducer paraquat, and the electron transport chain complex I inhibitor rotenone. The therapeutic potential of vatiquinone in vivo was assessed using the tamoxifen-induced mouse model for GPX4 deficiency and the Ndufs4 knockout mouse model of Leigh syndrome.

Results
Vatiquinone robustly prevented death in cultured cells induced by RSL3 or BSO/iron, but had no effect on paraquat induced cell death. Vatiquinone had no impact on disease onset, progression, or survival in either the tamoxifen-inducible GPX4 deficient model or the Ndufs4(-/-) mouse model, though the drug may have reduced seizure risk.

Conclusions
Vatiquinone prevents ferroptosis, but fails to attenuate cell death induced by paraquat or rotenone and provided no significant benefit to survival in two mouse models of disease. Vatiquinone may prevent seizures in the Ndufs4(-/-) model. Our findings are consistent with recent press statements regarding clinical trial results and have implications for drug trial design and reporting in patients with rare diseases.
ELK3-CYFIP2 axis-mediated actin remodeling modulates metastasis and natural killer cell responses in triple-negative breast cancer
Authors: Choi Seung Hee , Jang Hye Jung , Park Joo Dong , Ryu Ki Seo , Maeng Eunchong , Cho Seohyun , Park Hail , Jung Hae-Yun , Park Kyung-Soon 
Published: February 2025

Abstract
Triple-negative breast cancer (TNBC) is an aggressive, highly metastatic disease with a poor prognosis. E26 transformation-specific transcription factor (ELK3) is highly expressed in TNBCs, and functions as a regulator of epithelial-mesenchymal transition and immune responses. Because metastatic migration and immune evasion by TNBC cells are critical factors for successful metastasis, unravelling the underlying mechanisms and developing effective immunotherapeutic strategies is urgent. Here, TNBC cell lines MDA-MB-231 and Hs578T were examined to determine the relationship between ELK3 expression and filopodia protrusion on the cell membrane, as well as actin accumulation at contact sites with natural killer (NK) cells. RNA-sequencing analysis and molecular experiments were conducted to identify and validate downstream target genes of ELK3 associated with migration and attachment of TNBC cells. The immune response of TNBC to NK cells was evaluated through imaging and flow cytometry analyses. Clinical significance was assessed through Kaplan–Meier analysis of survival outcomes of TNBC patients. Gene expression profiling and molecular analysis revealed that oncogenic ELK3 directly suppresses expression of cytoplasmic FMR1 interacting protein2 (CYFIP2), a repressor of actin accumulation. Further molecular and pharmacological analyses confirmed that the ELK3-CYFIP2 axis serves a dual role in TNBC cell lines by (1) controlling filopodia-mediated migration and adhesion by regulating actin accumulation, and (2) regulating sensitivity to NK cells by modulating actin accumulation at contact sites. Kaplan–Meier analysis suggested that ELK3-CYFIP2 axis is associated with survival of TNBC patients, and that ELK3 suppresses transcription of CYFIP2. Thus, the ELK3-CYFIP2 axis plays a pivotal role in regulating actin, emphasizing its significance in controlling both cancer cell migration and NK cell responses in TNBC.
Vitamin D status of pediatric epilepsy patients and evaluation of affecting factors
Authors: Bilge Serap , Taşkın Sema Nur 
Published: February 2025

Abstract

Background
The use of antiseizure medication in patients with epilepsy is one of the significant risk factors associated with abnormal vitamin D status. We aimed to identify risk factors related to hypovitaminosis D in pediatric patients treated with antiseizure medications.

Method
A cross-sectional retrospective cohort study was conducted on 127 pediatric epilepsy patients who received antiseizure drugs from December 2021 to December 2022. Demographic data, seizure types, diet, physical activity, duration, and types of antiseizure medications were analyzed.

Results
Among the 127 patients in this study, 53% were male, and the mean age was 9,1 ± 4,6 years (range: 2–17). The mean serum 25(OH)D level at baseline in winter/autumn was 24,2 ± 14,2 ng/mL; 47.0% of the patients were 25(OH) D deficient, 23% were 25(OH)D insufficient, and 30% had a vitamin D level within the normal range. The vitamin 25(OH) D level was 27,6 ± 12,2 in the epilepsy group with non-enzyme-induced antiseizure drugs, 21,76 ± 19,7 in the group with enzyme-induced antiseizure drugs, and 13,96 ± 7,9 in the group with combined antiseizure drugs (p < 0.001).

Conclusion
The number of antiseizure drugs, treatment with enzyme-induced antiseizure drugs, duration of epilepsy, abnormalities in magnetic resonance imaging, and etiology play important roles in determining the vitamin D level.
Understanding depression in autism: the role of subjective perception and anterior cingulate cortex volume
Authors: Hao Yu , Banker Sarah , Trayvick Jadyn , Barkley Sarah , Peters Arabella W. , Thinakaran Abigaël , McLaughlin Christopher , Gu Xiaosi , Schiller Daniela , Foss-Feig Jennifer 
Published: February 2025

Abstract

Background
The prevalence of depression is elevated in individuals with autism spectrum disorder (ASD) compared to the general population, yet the reasons for this disparity remain unclear. While social deficits central to ASD may contribute to depression, it is uncertain whether social interaction behavior themselves or individuals’ introspection about their social behaviors are more impactful. Although the anterior cingulate cortex (ACC) is frequently implicated in ASD, depression, and social functioning, it is unknown if it explains differences between ASD adults with and without co-occurring depression.

Methods
The present study contrasted observed vs. subjective perception of autism symptoms and social interaction assessed with both standardized measures and a lab task, in 65 sex-balanced (52.24% male) autistic young adults. We also quantified ACC and amygdala volume with 7-Tesla structural neuroimaging to examine correlations with self-reported depression and social functioning.

Results
We found that ASD individuals with self-reported depression exhibited differences in subjective evaluations including heightened self-awareness of ASD symptoms, lower subjective satisfaction with social relations, and less perceived affiliation during the social interaction task, yet no differences in corresponding observed measures, compared to those without depression. Larger ACC volume was related to depression, greater self-awareness of ASD symptoms, and worse subjective satisfaction with social relations. In contrast, amygdala volume, despite its association with clinician-rated ASD symptoms, was not related to depression.

Limitations
Due to the cross-sectional nature of our study, we cannot determine the directionality of the observed relationships. Additionally, we included only individuals with an IQ over 60 to ensure participants could complete the social task. We also utilized self-reported depression indices instead of clinically diagnosed depression, which may limit the comprehensiveness of the findings.

Conclusions
Our approach highlights the unique role of subjective perception of autism symptoms and social interactions, beyond the observable manifestation of social impairment in ASD, in contributing to self-reported depression, with the ACC playing a crucial role. These findings imply possible heterogeneity of ASD concerning co-occurring depression. Using neuroimaging, we were able to demarcate depressive phenotypes co-occurring alongside autistic phenotypes.
Systemic oxidative stress levels and their associations with the risk of neovascular age-related macular degeneration and treatment response
Authors: Abe Maiko , Kunikata Hiroshi , Aizawa Naoko , Yasuda Masayuki , Nitta Fumihiko , Abe Toshiaki , Nakazawa Toru 
Published: February 2025

Abstract

Purpose
To investigate the association between oxidative stress (OS) and both the risk of neovascular age-related macular degeneration (nAMD) and the treatment response to intravitreal anti-vascular endothelial growth factor injections (anti-VEGF IVIs).

Methods
This retrospective study included 46 treatment-naïve nAMD eyes of 46 patients (26 male and 20 female) who received anti-VEGF IVIs with a “treat-and-extend” regimen following an initial loading phase for one year. The patients were divided into two groups according to the total number of anti-VEGF IVIs administered during the year: the “effective” group and the “resistant” group. OS was evaluated by diacron reactive oxygen metabolites (d-ROMs), biological antioxidant potential (BAP), and skin autofluorescence (SAF) at baseline. For comparison, 54 control subjects were recruited.

Results
There were no significant differences in d-ROM or BAP levels between control subjects and nAMD patients, regardless of sex, whereas SAF levels were higher in nAMD patients overall and in male nAMD patients than in controls (P < 0.001 for both). The effective and resistant groups included 30 and 16 eyes, respectively. Among the male nAMD patients, the effective and resistant groups had similar baseline characteristics, including age, smoking history, visual acuity, and central macular thickness; however, the resistant group had higher SAF levels (effective vs. resistant: 2.3 vs. 2.6 arbitrary units [AU]; P = 0.02). This finding was further supported by a multiple logistic regression analysis, which showed that the odds ratio for SAF was 1.57 per 0.1 AU increase (P = 0.01).

Conclusion
SAF levels were significantly higher in nAMD patients than in controls. The total number of anti-VEGF IVIs required over one year in male nAMD patients depended on SAF levels, suggesting that the SAF levels may serve as a potential biomarker for the response to anti-VEGF IVIs in nAMD.