bluuebunny/crossref_metadata_2025_split huggingface dataset:
Propuesta de requisitos para la aplicación de la Economía Circular en la restauración turística del destino La Habana
Authors: Romaní Bendig Beatriz , Ginarte López Sandra , Espinosa Manfugás Julia Ma , Velasteguí López Luis Efraín 
Published: February 2025

Introducción. ONU Turismo defiende la necesidad de emplear la economía circular para la innovación y hacer del turismo una actividad más sostenible. En Cuba se hace imprescindible desarrollar una estrategia que ponga en práctica la economía circular y su aplicación. En el caso del sector de la restauración, este es generador de grandes cantidades de residuos de alimentos y plásticos, lo que no contribuye a la sostenibilidad. El presente estudio está encaminado a la propuesta de requisitos de economía circular para favorecer el máximo rendimiento de los recursos disponibles, reduciendo al mínimo la generación de residuos; y además la creación de oportunidades para un sistema más sostenible e inclusivo. Objetivo. Proponer requisitos para la aplicación de la economía circular en la restauración turística del destino La Habana. Metodología. Para el cumplimiento de este objetivo se realizó una entrevista semiestructurada a los especialistas de calidad y operaciones de alimentos y bebidas del Ministerio de Turismo, y además, se aplicó un cuestionario a los especialistas de calidad y operaciones de alimentos y bebidas de las OSDES Hoteleras, Empresa Extrahotelera Palmares, Ministerio de Comercio Interior (Mincin), así como a los presidentes de la Asociación Culinaria de Cuba, la Asociación de Cantineros de Cuba y la Asociación de Sommeliers de Cuba. Se llevó a cabo una revisión de literatura especializada y normativas establecidas sobre esta temática. El procesamiento de los datos implicó el cálculo de frecuencias absolutas y relativas, el cálculo del índice del Alfa de Cronbach, así como la realización del Diagrama de Pareto. La validación de la propuesta se realizó por un grupo de expertos, a través del método de ANOCHI. Resultados. Los resultados de la investigación permitieron constatar que existe un marco regulatorio y legal en el país relacionado con la Economía Circular, pero de manera general su conocimiento en el sector turístico es aún incipiente, y que los retos vitales para la aplicación de la Economía Circular en restaurantes turísticos del destino La Habana son: la baja capacitación del personal, la falta de recursos en el destino y la carencia de infraestructura necesaria. Conclusión. La Estrategia para la Transición hacia una Economía Circular del Ministerio de Turismo, es uno de los pilares fundamentales para su desarrollo, siendo la sensibilización y capacitación de los recursos humanos factores claves para su avance. Se elaboró y validó la propuesta requisitos, la cual fue estructurada en requisitos generales y específicos, los que incluyen un total de 14 apartados. Área de estudio general: (Turismo). Área de estudio específica: (Economía Circular). Tipo de estudio: Artículos originales / Original articles.
Artificially intelligent nursing homes: a scoping review of palliative care interventions
Authors: Ronan Isabel , Tabirca Sabin , Murphy David , Cornally Nicola , Saab Mohamad M. , Crowley Patrice 
Published: February 2025

IntroductionThe world’s population is aging at a rapid rate. Nursing homes are needed to care for an increasing number of older adults. Palliative care can improve the quality of life of nursing home residents. Artificial Intelligence can be used to improve palliative care services. The aim of this scoping review is to synthesize research surrounding AI-based palliative care interventions in nursing homes.MethodsA PRISMA-ScR scoping review was carried out using modified guidelines specifically designed for computer science research. A wide range of keywords are considered in searching six databases, including IEEE, ACM, and SpringerLink.ResultsWe screened 3255 articles for inclusion after duplicate removal. 3175 articles were excluded during title and abstract screening. A further 61 articles were excluded during the full-text screening stage. We included 19 articles in our analysis. Studies either focus on intelligent physical systems or decision support systems. There is a clear divide between the two types of technologies. There are key issues to address in future research surrounding palliative definitions, data accessibility, and stakeholder involvement.DiscussionThis paper presents the first review to consolidate research on palliative care interventions in nursing homes. The findings of this review indicate that integrated intelligent physical systems and decision support systems have yet to be explored. A broad range of machine learning solutions remain unused within the context of nursing home palliative care. These findings are of relevance to both nurses and computer scientists, who may use this review to reflect on their own practices when developing such technology.
Analysis of tumor-infiltrating exhausted T cells highlights IL-6 and PD1 blockade as a combined immunotherapy strategy for non-small cell lung cancer
Authors: Zhang Lulu , Guo Xiyuan , Sun Xiaoke , Liao Jue , Liu Qin , Ye Yingchun , Yang Zhihui , Cressey Ratchada , He Qing , Yuan Qing 
Published: February 2025

ObjectiveGiven the limitations of immunotherapy for treating non-small cell lung cancer (NSCLC), we investigated the phenotype and function of exhausted CD8+T cells and analyzed a novel combination immunotherapy to restore the effector killing function of tumor-infiltrating CD8+T lymphocyte (TIL).MethodsWe examined the expression and function of immunosuppressive molecules on CD8+T cells of peripheral blood mononuclear cells (PBMCs) and TILs by using prospectively collected peripheral blood, pleural effusions, and tumor tissues from patients with NSCLC and correlated the results with clinical data. We then evaluated the effect of interleukin 6 (IL-6) stimulation on CD8+T cells. Finally, we assessed the effects of combined blockade of PD1 and IL-6 on macrophage recruitment in a zebrafish macrophage model and CD8+ T cell function and tumor growth in PBMC humanized mouse model.ResultsThe expression of exhaustion markers on CD8+ T cells was found to be notably higher in both tumor and paraneoplastic tissues compared to peripheral blood. Furthermore, the degree of CD8+ T cell exhaustion exhibited a progressive increase with proximity to the tumor. When CD8+ T cells from peripheral blood and tumor tissues of NSCLC patients were stimulated with IL-6, the expression level of exhaustion markers, especially PD1, was further elevated. In the in vitro experiment, the combined inhibition of IL-6 and PD1 substantially enhanced the effector killing function of CD8+ T cells in NSCLC pleural effusion samples. In a macrophage-labeled zebrafish model, combined blockade of IL-6 and PD1 enhanced the recruitment of macrophages. In PBMC humanized mouse model, combined blockade of IL-6 and PD1 enhanced the inhibition of tumor growth.ConclusionOur data suggest that CD8+ T cells in NSCLC patients were in a state of exhaustion and combined blockade of IL-6 and PD1 to restore CD8+ T cell function to inhibit tumor growth may be an effective clinical strategy for the treatment of NSCLC.
Dicoumarol sensitizes hepatocellular carcinoma cells to ferroptosis induced by imidazole ketone erastin
Authors: Yang Ziwei , Han Tixin , Yang Ruibin , Zhang Yinuo , Qin Yifei , Hou Jialu , Huo Fei , Feng Zhuan , Ding Yaxin , Yang Jiali , Zhou Gang , Wang Shijie , Xie Xiaohang , Lin Peng , Chen Zhi-Nan , Wu Jiao 
Published: February 2025

IntroductionFerroptosis, an iron-dependent form of regulated cell death, is characterized by the lethal accumulation of lipid peroxides on cellular membranes. It not only inhibits tumor growth but also enhances immunotherapy responses and overcomes drug resistance in cancer therapy. The inhibition of the cystine-glutamate antiporter, system Xc–, induces ferroptosis. Imidazole ketone erastin (IKE), an inhibitor of the system Xc– functional subunit solute carrier family 7 member 11 (SLC7A11), is an effective and metabolically stable inducer of ferroptosis with potential in vivo applications. However, tumor cells exhibited differential sensitivity to IKE-induced ferroptosis. The intrinsic factors determining sensitivity to IKE-induced ferroptosis remain to be explored to improve its efficacy.MethodsBulk RNA-sequencing data from hepatocellular carcinoma (HCC) and normal liver tissues were collected from The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) databases. Differentially expressed genes were identified and intersected with the ferroptosis-related genes (FRGs) listed in the FerrDb database, yielding the identification of 13 distinct FRGs.ResultsA ferroptosis signature index model (Risk Score) was developed to predict HCC prognosis. And SLC7A11 and NAD(P)H quinone dehydrogenase 1 (NQO1) were identified as candidate FRGs indicating poor prognosis of HCC. Dicoumarol (DIC), an inhibitor of NQO1, was subsequently employed to assess its sensitizing effects on IKE in HCC treatment. In HCC cell lines and the subcutaneous xenograft model, the combined suppression of SLC7A11 and NQO1 significantly enhanced the inhibitory effect on tumor growth by inducing ferroptosis.DiscussionIn conclusion, our findings demonstrate that DIC sensitized HCC cells to IKE-induced ferroptosis in HCC. Moreover, the identification of potential drugs that enhance the susceptibility of HCC cells to ferroptosis could provide novel therapeutic strategies for the treatment of HCC.
Planetary health education in undergraduate medical education in Germany: results from structured interviews and an online survey within the national PlanetMedEd Project
Authors: Grieco Fabio , Parisi Sandra , Simmenroth Anne , Eichinger Michael , Zirkel Janina , König Sarah , Jünger Jana , Geck Eva , Schwienhorst-Stich Eva-Maria 
Published: February 2025

BackgroundIn light of the accumulating evidence, awareness and urgency to act upon the three planetary crises – climate change, biodiversity loss, and pollution – the concept of Planetary Health underscores their profound implications for health and promotes actionable solutions to advance both wellbeing and ecological sustainability. Despite (inter)national calls to integrate Planetary Health into health workers’ curricula, the current status of Planetary Health Education in undergraduate medical education in Germany is unclear. This study therefore aimed (a) to assess the current implementation of Planetary Health in undergraduate medical education in Germany and (b) to explore its characteristics as a foundation to develop evidence-informed recommendations for mainstreaming Planetary Health Education in medical schools in Germany.MethodsThe study comprised structured interviews followed by an online survey, both targeting all 39 medical schools in Germany. In 2021, structured interviews were conducted with students, educators and deanery staff at medical schools. In 2023, educators and deanery staff participated in an online survey based on the findings from the interviews.FindingsIn total, 80% of the 39 medical schools participated in the interviews, while 90% took part in the online survey. Based on integrated findings, 35 medical schools (90%) offered Planetary Health Education, with a median of two educational activities, including both stand-alone courses and lectures integrated into other courses. Despite an overall increase since winter semester 2021/2022, most educational activities were electives and not part of the mandatory curriculum. Innovative educational approaches and learning objectives differed significantly between mandatory and elective formats. In contrast to mandatory educational activities, student involvement was reported for the majority of electives and was significantly associated with transformative learning objectives.InterpretationDespite a steady rise in teaching activities, mandatory Planetary Health Education remains insufficiently integrated into undergraduate medical education in Germany. Key criteria defining high-quality Planetary Health Education, such as innovative educational approaches, practical skills, and transformative learning, were primarily reflected in electives, that reach only a minority of students. To adequately equip the future healthcare workforce, the current barriers to successfully integrating Planetary Health into medical education must be systematically addressed and overcome.
Proteogenomic annotation of T6SS components identified in Bacteroides fragilis secretome
Authors: Zakharzhevskaya Natalya B. , Shagaleeva Olga Yu , Kashatnikova Daria A. , Goncharov Anton O. , Evsyutina Daria V. , Kardonsky Dmitry A. , Vorobeva Elizaveta A. , Silantiev Artemiy S. , Kazakova Viktoria D. , Kolesnikova Irina V. , Butenko Ivan O. , Vanyushkina Anna A. , Smirnova Svetlana V. , Chaplin Andrei V. , Efimov Boris A. 
Published: February 2025

IntroductionBacteroides fragilis (Bf)’s T6SS locus has been characterized and shown to have functional activity in competition experiments. It has been demonstrated that symbiont nontoxigenic Bf strains have a more effective “weapon” effect on pathogenic Bf, which is realized through the activity of effector-immune (E-I) protein pairs. Intensive study of the T6SS structure has led to an understanding of certain issues related to its functional activity, but the exact regulatory mechanisms of E-I protein pair activity remain unclear. Proteomic annotation of T6SS components and detailed descriptions of all immune-effector pairs are currently available. In this research, we performed detailed proteogenomic analysis and subsequent proteomic annotation of the T6SS components of the toxigenic Bf BOB25.Material and methodsFractionated cells, cultivated media and vesicles were prepared for proteome analysis by HPLC-MS/MS. Proteogenomic annotation and comparative genomic study of the T6SS loci of the toxigenic Bf BOB25 were carried out by comparison with the reference genomes of the following Bf strains: JIM10, NCTC 9343 and 638R.ResultsAccording to the data obtained, T6SS components were represented in all types of the analysed samples. The following components of the T6SS were identified in culture media and cells: ClpV (TssH), TssK, TssC, TssB, Hcp (TssD), and TetR. The predicted effector protein AKA51715.1 (VU15_08315) was also detected in media. The greatest amount of T6SS proteins, including the Hcp protein, was detected in the vesicle samples, which was also observed by TEM. Potential effectors, including AKA51715.1 (VU15_08315), AKA51716.1 (VU15_08320), AKA51728.1 (VU15_08385) and the immune protein AKA51727.1 (VU15_08380), were detected in vesicles.DiscussionThe presence of the immune and effector proteins in the Bf secretome indicates the high activity of the T6SS without bacterial competition. It is possible that the T6SS is also used by bacteria to regulate population size by altering the activity of different repertoires of E-I pairs.
Feasibility of home-based transcranial direct current stimulation combined with personalized word retrieval for improving naming in primary progressive aphasia
Authors: George Allan , McConathey Eric , Vogel-Eyny Amy , Galletta Elizabeth , Pilloni Giuseppina , Charvet Leigh 
Published: February 2025

Background/ObjectivesPrimary progressive aphasia (PPA) is managed with speech-language therapy (SLT) to slow language decline. Pairing transcranial direct current stimulation (tDCS) with SLT can enhance its effects. However, further research is needed to confirm these findings and guide its clinical use. We evaluated the feasibility of providing an intervention combining tDCS with SLT as a home-based and remotely supervised intervention.MethodsParticipants with confirmed PPA who had word-finding difficulties were recruited for an open-label observational study. The intervention consisted of 20 daily sessions over 1 month, each with 45-min of personalized word retrieval training. During the first 30-min, participants received tDCS over the left inferior frontal gyrus (anode F7, cathode O1) at 2.0 mA. Language measures were remotely administered at baseline and intervention end.ResultsWe enrolled 10 patients (age: 70 ± 7 years; 60% male) with confirmed logopenic variant (n = 2), semantic variant (n = 2), or unspecified (n = 6) PPA. The intervention was well-tolerated with no treatment-limiting adverse events. All participants completed all sessions, confirming the feasibility of the home-based treatment. There were no declines in language functioning measures, with improved naming for trained vs. untrained items (p = 0.003) and a significant improvement in confrontation naming (p = 0.016) from baseline to intervention end.ConclusionsOur case series demonstrates that home-based tDCS added to SLT is feasible for patients with PPA. However, larger controlled studies are required to confirm its effectiveness in slowing language decline and to fully determine the benefits of this approach. This approach not only facilitates broader access to participation but also enables the extended treatment necessary to evaluate its clinical benefits, moving this treatment closer to clinical availability as a telehealth treatment.
Dietary index for gut microbiota and its protective role against kidney stones: evidence of diabetes as a mediator from NHANES cross-sectional data
Authors: Wang Lei , Wu Junjun , Jiang Ziwen , Wang Chao , Lin Fuxiang , Zhong Yuxiang , Zhao Pengpeng , Wei Wei , Huang Jianhua , Xu Zhanping 
Published: February 2025

BackgroundThe dietary index for gut microbiota (DI-GM) reflects dietary patterns that support gut microbial health and may influence kidney stone (KS) risk. The role of DI-GM and its mediation by diabetes in KS pathogenesis remains unclear.ObjectiveTo investigate the association between DI-GM and KS prevalence, assess the mediation effect of diabetes, and explore subgroup-specific effects and underlying mechanisms.MethodsA cross-sectional analysis of NHANES (2007–2018) data was conducted using a stratified, multistage probability sampling design. A total of 19,841 participants were included in the final analysis. Data entry and statistical analysis were performed using Empower version 4.2 (X&amp;Y Solutions, Inc., Boston, MA, United States) and R version 3.4.3 (R Foundation). Multivariable logistic regression was employed to assess the association between DI-GM and KS prevalence, with statistical significance set at p &lt; 0.05. Mediation analysis evaluated diabetes’s contribution to this relationship, and subgroup analyses were conducted based on sex, race/ethnicity, and alcohol consumption.ResultsHigher DI-GM scores were associated with lower KS prevalence (adjusted OR: 0.78, 95% CI: 0.65–0.92 per SD increase). Diabetes mediated 9.27% of this relationship. Subgroup analyses revealed stronger protective effects among females, non-Hispanic Black individuals, and heavy drinkers. Mechanistically, DI-GM may reduce KS risk through gut microbial modulation of oxalate metabolism, urinary citrate excretion, and systemic inflammation.Conclusion and recommendationsHigher DI-GM scores are associated with reduced KS prevalence, partially mediated by diabetes. These findings highlight the role of dietary interventions targeting gut microbiota in KS prevention and call for longitudinal studies to confirm these results and develop tailored dietary strategies.
A synergistic effect of secondhand smoke with vitamin D deficiency on cognitive impairment in older adults: a cross sectional study
Authors: Li Yan , Shen Qianqian , Chen Chengyu , Yin Xueru , Wang Xinru , Yang Xiyue , Zhang Xueqian , Chen Lei , Xu Jian , Gong Guifang 
Published: February 2025

ObjectivesTo investigate whether exposure to secondhand smoke (SHS) aggravates the detrimental effect of vitamin D deficiency (VDD) on cognitive performance in the elderly.MethodsBased on National Health and Nutrition Examination Surveys (NHANES) 2011–2014, 1,446 non-smoking participants (≥ 60 years old) with detailed serum 25-hydroxyvitamin D [25(OH)D], concentration of cotinine and tests score of cognitive function were included. Cognitive impairment was defined as having a cognitive score in the lowest quartile. The possible synergistic effect of SHS with VDD on cognitive impairment was evaluated by using a multivariable logistic regression model.ResultsVDD was independently associated with risk of low the Digit Symbol Substitution Test (DSST) scores, increased by nearly 60% [&lt; 34, adjusted odds ratio (aOR) = 1.62, 95% CI: 1.03 ~ 2.53]. Although it only had an association with cognitive impairment indicated by DSST and the Animal Fluency test (AFT) in the crude model, SHS exposure showed significant synergistic effects with VDD on DSST (aOR: 3.03, 95% CI: 1.57 ~ 5.83, Pinteraction = 0.001) and AFT (aOR: 2.40, 95% CI: 1.34 ~ 4.29, Pinteraction = 0.003), respectively, after adjusting for the possible confounders. In further stratified analysis, a more obvious synergistic effect of SHS with VDD on DSST (aOR: 4.73, 95%CI:1.77 ~ 12.68, Pinteraction = 0.002) and AFT (aOR: 5.30, 95%CI: 1.63 ~ 17.24, Pinteraction = 0.006) was found in obese and overweight subjects, respectively.ConclusionSHS exposure had synergistic effect with VDD on cognitive impairment among elderly and the interaction effect was more obvious in overweight and obese individuals.
The influence of menopause age on gynecologic cancer risk: a comprehensive analysis using NHANES data
Authors: Abulajiang Yiliminuer , Liu Tao , Wang Ming , Abulai Abidan , Wu Yumei 
Published: February 2025

BackgroundMenopause, a natural transition, affects women’s health risks, including gynecologic cancers. Early menopause, linked to lower estrogen, may increase cancer susceptibility. This study analyzed NHANES data from 1999 to 2020 for 8,219 postmenopausal women to explore the relationship between menopausal age and gynecologic cancers. We used regression models and RCS models to assess the risk.MethodsThis study utilized data from the NHANES spanning 1999 to 2020, focusing on 8,219 postmenopausal women selected through stratified sampling. Variables including socioeconomic factors, health behaviors, nutritional status, and medical history were assessed in relation to participants’ menopausal age and gynecologic cancer prevalence. We analyzed the relationship between menopausal age and gynecologic cancers (cervical, ovarian, and uterine) using multiple regression models. Additionally, we employed RCS models to evaluate nonlinear relationships between menopausal age and gynecologic cancer risk.ResultsOur findings indicate a significant inverse association between menopausal age and the risk of gynecologic cancers. After controlling for confounding factors such as age, race, BMI, and lifestyle variables, a later age at menopause was associated with a reduced risk of cervical, ovarian, and uterine cancers. The RCS model revealed a non-linear, low-L-shaped relationship, particularly highlighting increased cancer risks at younger menopausal ages. Subgroup analyses demonstrated consistent results across demographic and lifestyle factors, confirming the robustness of the observed associations.ConclusionThis study reveals the link between menopausal age and gynecologic cancer prevalence. Early menopause is a significant risk factor for cervical, ovarian, and uterine cancers. Our findings support tailored cancer screening based on menopausal age, potentially improving preventive care for postmenopausal women.