bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive Function and Participation of Stroke Survivors Living With Companion Animals: A Cross-Sectional Study
Authors: Demeter Naor , Zilcha-Mano Sigal , Zukerman Sandra , Josman Naomi 
Published: March 2024

Introduction/Objectives: Companion animals (CAs) may benefit human health, but few studies have examined their impact on stroke survivors. This study examines participation, quality of life (QoL), attachment, cognition, and executive function differences between stroke survivors living with and without CAs. Methods: In this cross-sectional, community-setting study, 25 stroke survivors with a CA and a matched group of 27 without a CA completed standard tools. Results: Stroke survivors with a CA scored significantly higher in participation and 1 cognitive performance test. No significant differences were found in other cognitive measures or QoL, and attachment to a CA was not correlated with participation or QoL within the research group. However, lower attachment avoidance correlated with better participation in survivors living with dogs. Conclusion: Living with CAs, especially dogs, might be associated with some cognitive function and participation benefits among stroke survivors. The link between CAs and cognitive function is unclear: Survivors with higher cognitive functioning might be more capable of caring for a CA, or having and caring for a CA might promote better cognitive function. Attachment patterns also might explain stroke survivors’ participation levels. Further study is warranted.
Evaluation of Differences in Patellar Height After Patellar Stabilization Procedures Not Intended to Address Patella Alta: A Multicenter Study
Authors: Kreulen R. Timothy , Anderson Gregory , Yalcin Sercan , Hart Joseph M. , Shank Kaitlyn , Fury Matthew S. , Elias John J. , Tanaka Miho J. , Farrow Lutul D. , Diduch David R. , Cosgarea Andrew J. 
Published: March 2024

Background: Recent studies have reported conflicting results as to whether isolated medial patellofemoral ligament reconstruction (MPFLr) leads to decreased patellar height. Purpose: To investigate if patellar stabilization surgery not intended to address patella alta influences patellar height. Study Design: Cohort study; Level of evidence, 3. Methods: A multicenter retrospective chart review was conducted, and patients who underwent MPFLr, medializing tibial tuberosity osteotomy (TTO), and/or trochleoplasty between 2016 and 2020 were included. The Caton-Deschamps index (CDI) was calculated from radiographs obtained preoperatively, 2 weeks postoperatively, and 3 months postoperatively. The preoperative CDI value was compared with the 2-week postoperative and 3-month postoperative values according to stabilization procedure (isolated MPFLr, isolated TTO, MPFLr + TTO, MPFLr + trochleoplasty, and MPFLr + trochleoplasty + TTO) using the paired t test. Analyses of the 1-bundle versus 2-bundle MPFLr technique and the presence of lateral retinacular release or lateral retinacular lengthening were conducted on the isolated MPFLr and combined MPFLr + TTO cohorts. Results: A total of 356 knees were included. Statistically significant pre- to postoperative decreases in CDI were seen in all stabilization procedures analyzed ( P≤ .017 for all). Within the isolated MPFLr cohort, this significant decrease was seen at 2 weeks postoperatively with the 2-bundle technique (ΔCDI = −0.09; P < .001) but not with the 1-bundle technique (ΔCDI = −0.01; P = .621). Conclusion: The different surgical techniques analyzed in the current study affected patellar height, even when a distalizing TTO was not performed. The decrease was dependent on surgical technique, with a 2-bundle MPFLr leading to a statistically significant decrease and a 1-bundle MPFLr effecting no change.
Perception of Nursing Students About Effective Clinical Teaching Environments: A Multi-Country Study
Authors: Al-Daken Laila , Lazarus Eilean R. , Al Sabei Sulaiman D. , Alharrasi Maryam , Al Qadire Mohammad 
Published: March 2024

Background The transition of nursing education from traditional methods to more advanced approaches is crucial for adequately preparing students to deliver competent care in tertiary care centers. Moreover, clinical faculty in nursing plays a key role in guiding nursing students through their clinical training in various healthcare settings. Purpose This study aims to describe the perceptions of undergraduate nursing students regarding the effectiveness of the learning environment and clinical teaching in clinical areas across various countries. Methods The study, conducted using a descriptive, cross-sectional research design, gathered data from 215 nursing students using the Clinical Learning Environment Inventory and Clinical Teaching Effectiveness Instrument. Data analysis included frequencies, percentages, mean, standard deviation, t-tests, analysis of variance, and correlation assessments to comprehend the impact of clinical teaching and learning environments. Results Nursing students’ perceptions of the clinical learning environment produced mean scores between 2.03 and 3.38 on a scale from 1 to 4, resulting in an overall mean score of 2.72 across 42 items. This indicates a general satisfaction with their clinical learning experiences. Regarding effective clinical teaching, the mean student responses varied from 3.02 to 3.40 out of a possible 5 points, with a total mean of 3.22. The study revealed notable correlations in the context of effective clinical teaching, particularly with demographic variables and the clinical learning environment. Specifically, a significant correlation with age ( r = .177, p = .009) and the clinical learning environment ( r = .572, p < .001) was identified. Conclusion The study concludes that students expressed overall satisfaction with their clinical learning experiences. They recognized the importance of participating in clinical training, fulfilling clinical responsibilities for assigned patients, exerting extra effort for learning, receiving support from preceptors in clinical settings, and being attentive to communications from staff. The collaboration between clinical preceptors and academic nursing lecturers is crucial in providing a positive learning environment for students to complete clinical tasks effectively.
Burden of intracranial artery calcification in white patients with ischemic stroke
Authors: Berghout Bernhard P , Camarasa Robin YR , Van Dam-Nolen Dianne HK , van der Lugt Aad , de Bruijne Marleen , Koudstaal Peter J , Ikram M Kamran , Bos Daniel 
Published: March 2024

Introduction: The diagnostic workup of stroke doesn’t identify an underlying cause in two-fifths of ischemic strokes. Intracranial arteriosclerosis is acknowledged as a cause of stroke in Asian and Black populations, but is underappreciated as such in whites. We explored the burden of Intracranial Artery Calcification (IAC), a marker of intracranial arteriosclerosis, as a potential cause of stroke among white patients with recent ischemic stroke or TIA. Patients and methods: Between December 2005 and October 2010, 943 patients (mean age 63.8 (SD ± 14.0) years, 47.9% female) were recruited, of whom 561 had ischemic stroke and 382 a TIA. CT-angiography was conducted according to stroke analysis protocols. The burden of IAC was quantified on these images, whereafter we assessed the presence of IAC per TOAST etiology underlying the stroke and assessed associations between IAC burden, symptom severity, and short-term functional outcome. Results: IAC was present in 62.4% of patients. Furthermore, IAC was seen in 84.8% of atherosclerotic strokes, and also in the majority of strokes with an undetermined etiology (58.5%). Additionally, patients with larger IAC burden presented with heavier symptoms (adjusted OR 1.56 (95% CI [1.06–2.29]), but there was no difference in short-term functional outcome (1.14 [0.80–1.61]). Conclusion: IAC is seen in the majority of white ischemic stroke patients, aligning with findings from patient studies in other ethnicities. Furthermore, over half of patients with a stroke of undetermined etiology presented with IAC. Assessing IAC burden may help identify the cause in ischemic stroke of undetermined etiology, and could offer important prognostic information.
Cytoreductive therapy in younger adults with polycythemia vera: a meta-analysis of safety and outcomes
Authors: Chamseddine Reem S. , Savenkov Oleksandr , Rana Shehroz , Khalid Mohammed , Silver Richard T. , Kucine Nicole , Scandura Joseph M. , Abu-Zeinah Ghaith 
Published: March 2024

Abstract
Cytoreductive therapy is not routinely recommended for younger patients with polycythemia vera (PV) due to concern that treatment toxicity may outweigh therapeutic benefits. However, no systematic data support this approach. To support objective risk/benefit assessment of cytoreductive drugs in patients with PV aged &lt;60 years (PV&lt;60), this systematic review and meta-analysis was conducted to evaluate toxicity and disease-related complications in PV&lt;60 treated with interferon alfa (rIFN-α) or hydroxyurea (HU). A search of PubMed, Scopus, Web of Science and Embase identified 693 unique studies with relevant keywords, of which 14 met inclusion criteria and were selected for analysis. The weighted average age of patients treated with rIFN-α was 48 years (n = 744 patients; 12 studies) and for HU was 56 years (n = 1397; 8 studies). The weighted average duration of treatment for either drug was 4.5 years. Using a Bayesian hierarchical model, the pooled annual rate of discontinuation due to toxicity was 5.2% for patients receiving rIFN-α (n = 587; 95% confidence interval [CI], 2.2-8.2) and 3.6% for HU (n = 1097; CI, 1-6.2). The average complete hematologic response for rIFN-α and HU was 62% and 52%, respectively. Patients experienced thrombotic events at a pooled annual rate of 0.79% and 1.26%; secondary myelofibrosis at 1.06% and 1.62%; acute myeloid leukemia at 0.14% and 0.26%; and death at 0.87% and 2.65%, respectively. No treatment-related deaths were reported. With acceptable rates of nonfatal toxicity, cytoreductive treatment, particularly with disease-modifying rIFN-α, may benefit PV&lt;60. Future randomized trials prioritizing inclusion of PV&lt;60 are needed to establish a long-term benefit of early cytoreductive treatment in these patients.
Comparative mitogenomic analysis of subterranean and surface amphipods (Crustacea, Amphipoda) with special reference to the family Crangonyctidae
Authors: Benito Joseph B. , Porter Megan L. , Niemiller Matthew L. 
Published: March 2024

AbstractMitochondrial genomes play important roles in studying genome evolution, phylogenetic analyses, and species identification. Amphipods (Class Malacostraca, Order Amphipoda) are one of the most ecologically diverse crustacean groups occurring in a diverse array of aquatic and terrestrial environments globally, from freshwater streams and lakes to groundwater aquifers and the deep sea, but we have a limited understanding of how habitat influences the molecular evolution of mitochondrial energy metabolism. Subterranean amphipods likely experience different evolutionary pressures on energy management compared to surface-dwelling taxa that generally encounter higher levels of predation and energy resources and live in more variable environments. In this study, we compared the mitogenomes, including the 13 protein-coding genes involved in the oxidative phosphorylation (OXPHOS) pathway, of surface and subterranean amphipods to uncover potentially different molecular signals of energy metabolism between surface and subterranean environments in this diverse crustacean group. We compared base composition, codon usage, gene order rearrangement, conducted comparative mitogenomic and phylogenomic analyses, and examined evolutionary signals of 35 amphipod mitogenomes representing 13 families, with an emphasis on Crangonyctidae. Mitogenome size, AT content, GC-skew, gene order, uncommon start codons, location of putative control region (CR), length of rrnL and intergenic spacers differed between surface and subterranean amphipods. Among crangonyctid amphipods, the spring-dwelling Crangonyx forbesi exhibited a unique gene order, a long nad5 locus, longer rrnL and rrnS loci, and unconventional start codons. Evidence of directional selection was detected in several protein-encoding genes of the OXPHOS pathway in the mitogenomes of surface amphipods, while a signal of purifying selection was more prominent in subterranean species, which is consistent with the hypothesis that the mitogenome of surface-adapted species has evolved in response to a more energy demanding environment compared to subterranean amphipods. Overall, gene order, locations of non-coding regions, and base-substitution rates points to habitat as an important factor influencing the evolution of amphipod mitogenomes.
Uncovering a multitude of stage-specific splice variants and putative protein isoforms generated along mouse spermatogenesis
Authors: Romeo-Cardeillac Carlos , Trovero María Fernanda , Radío Santiago , Smircich Pablo , Rodríguez-Casuriaga Rosana , Geisinger Adriana , Sotelo-Silveira José 
Published: March 2024

Abstract
Background
Mammalian testis is a highly complex and heterogeneous tissue. This complexity, which mostly derives from spermatogenic cells, is reflected at the transcriptional level, with the largest number of tissue-specific genes and long noncoding RNAs (lncRNAs) compared to other tissues, and one of the highest rates of alternative splicing. Although it is known that adequate alternative-splicing patterns and stage-specific isoforms are critical for successful spermatogenesis, so far only a very limited number of reports have addressed a detailed study of alternative splicing and isoforms along the different spermatogenic stages.

Results
In the present work, using highly purified stage-specific testicular cell populations, we detected 33,002 transcripts expressed throughout mouse spermatogenesis not annotated so far. These include both splice variants of already annotated genes, and of hitherto unannotated genes. Using conservative criteria, we uncovered 13,471 spermatogenic lncRNAs, which reflects the still incomplete annotation of lncRNAs. A distinctive feature of lncRNAs was their lower number of splice variants compared to protein-coding ones, adding to the conclusion that lncRNAs are, in general, less complex than mRNAs. Besides, we identified 2,794 unannotated transcripts with high coding potential (including some arising from yet unannotated genes), many of which encode unnoticed putative testis-specific proteins. Some of the most interesting coding splice variants were chosen, and validated through RT-PCR. Remarkably, the largest number of stage-specific unannotated transcripts are expressed during early meiotic prophase stages, whose study has been scarcely addressed in former transcriptomic analyses.

Conclusions
We detected a high number of yet unannotated genes and alternatively spliced transcripts along mouse spermatogenesis, hence showing that the transcriptomic diversity of the testis is considerably higher than previously reported. This is especially prominent for specific, underrepresented stages such as those of early meiotic prophase, and its unveiling may constitute a step towards the understanding of their key events.
Genome-wide characterization of the bHLH gene family in Gynostemma pentaphyllum reveals its potential role in the regulation of gypenoside biosynthesis
Authors: Qin Yanhong , Li Jinmei , Chen Jianhua , Yao Shaochang , Li Liangbo , Huang Rongshao , Tan Yong , Ming Ruhong , Huang Ding 
Published: March 2024

Abstract
Background
Gynostemma pentaphyllum, an ancient Chinese herbal medicine, serves as a natural source of gypenosides with significant medicinal properties. Basic helix-loop-helix (bHLH) transcription factors play pivotal roles in numerous biological processes, especially in the regulation of secondary metabolism in plants. However, the characteristics and functions of the bHLH genes in G. pentaphyllum remain unexplored, and their regulatory role in gypenoside biosynthesis remains poorly elucidated.

Results
This study identified a total of 111 bHLH members in G. pentaphyllum (GpbHLHs), categorizing them into 26 subgroups based on shared conserved motif compositions and gene structures. Collinearity analysis illustrated that segmental duplications predominately lead to the evolution of GpbHLHs, with most duplicated GpbHLH gene pairs undergoing purifying selection. Among the nine gypenoside-related GpbHLH genes, two GpbHLHs (GpbHLH15 and GpbHLH58) were selected for further investigation based on co-expression analysis and functional prediction. The expression of these two selected GpbHLHs was dramatically induced by methyl jasmonate, and their nuclear localization was confirmed. Furthermore, yeast one-hybrid and dual-luciferase assays demonstrated that GpbHLH15 and GpbHLH58 could bind to the promoters of the gypenoside biosynthesis pathway genes, such as GpFPS1, GpSS1, and GpOSC1, and activate their promoter activity to varying degrees.

Conclusions
In conclusion, our findings provide a detailed analysis of the bHLH family and valuable insights into the potential use of GpbHLHs to enhance the accumulation of gypenosides in G. pentaphyllum.
An empirical evaluation of approximate and exact regression-based causal mediation approaches for a binary outcome and a continuous or a binary mediator for case-control study designs
Authors: Caubet Miguel , L’Espérance Kevin , Koushik Anita , Lefebvre Geneviève 
Published: March 2024

AbstractBackgroundIn the causal mediation analysis framework, several parametric regression-based approaches have been introduced in past years for decomposing the total effect of an exposure on a binary outcome into a direct effect and an indirect effect through a target mediator. In this context, a well-known strategy involves specifying a logistic model for the outcome and invoking the rare outcome assumption (ROA) to simplify estimation. Recently, exact estimators for natural direct and indirect effects have been introduced to circumvent the challenges prompted by the ROA. As for the approximate approaches relying on the ROA, these exact approaches cannot be usedas ison case-control data where the sampling mechanism depends on the outcome.MethodsConsidering a continuous or a binary mediator, we empirically compare the approximate and exact approaches using simulated data under various case-control scenarios. An illustration of these approaches on case-control data is provided, where the natural mediation effects of long-term use of oral contraceptives on ovarian cancer, with lifetime number of ovulatory cycles as the mediator, are estimated.ResultsIn the simulations, we found few differences between the performances of the approximate and exact approaches when the outcome was rare, both marginally and conditionally on variables. However, the performance of the approximate approaches degraded as the prevalence of the outcome increased in at least one stratum of variables. Differences in behavior were also observed among the approximate approaches. In the data analysis, all studied approaches were in agreement with respect to the natural direct and indirect effects estimates.ConclusionsIn the case where a violation of the ROA applies or is expected, approximate mediation approaches should be avoided or used with caution, and exact estimators favored.
Training Australian general practitioners to counsel women experiencing intimate partner abuse (WEAVE): a pre-post training analysis
Authors: Young Felicity , Hameed Mohajer , Hooker Leesa , Taft Angela , Hegarty Kelsey 
Published: March 2024

Abstract
Background
Evaluations of Intimate Partner Abuse training for general practitioners is limited. The Women’s Evaluation of Abuse and Violence Care study trialled in Australia was a primary care intervention that included delivering the Health Relationships training, a program that educates practitioners on how to provide supportive counselling and assistance to women afraid of an intimate partner. We report on effectiveness of the Healthy Relationships training program within a cluster-randomised controlled trial.

Methods
General practitioners filled out a baseline survey and surveys before and after training, including quantitative and open-text questions on barriers and enablers to supporting victim-survivors. The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool, a validated measure, was included to assess practitioner knowledge, skills, confidence, and attitudes. General linear model repeated analysis of variance tested the difference between trial groups over time.

Results
Fifty-two general practitioners completed the baseline demographic survey, with 65% (19 intervention, 18 comparison) completing both pre-and-post-training surveys. There were no between-group differences in baseline characteristics. Post-training, the intervention group had significantly higher average scores than the comparison on perceived preparation to address abuse (p = .000), perceived knowledge (p = .000), actual knowledge (p = .03), and greater awareness of practice-related issues (p = .000). There were no between-group differences in PREMIS opinion domain scores on workplace issues, self-efficacy and understanding of victims. Post-training, the qualitative data indicated that the intervention practitioners (n = 24) reported increased knowledge, awareness, and confidence, while time pressures and lack of referral options impeded addressing abuse.

Conclusion
The Healthy Relationships Training program for general practitioners increased aspects of practitioner knowledge, skills, and confidence. However, more support is needed to change opinions and support victim-survivors sustainably.

Trial registration
The WEAVE trial was registered on 21/01/2008 with the Australian New Zealand Clinical Trial Registry, number ACTRN12608000032358.
Relationship between perceived social support and disability with the mediating role of perceived stress among older adults
Authors: Dehghankar Leila , Valinezhad Saman , Amerzadeh Mohammad , Zarabadi Poor Farnoosh , Hosseinkhani Zahra , Motalebi Seyedeh Ameneh 
Published: March 2024

Abstract
Background
Social support is essential for individuals to cope with difficult circumstances. Older adults with disabilities face significant challenges in engaging with everyday activities. The current study examines the mediating role of perceived stress in the association between perceived social support and disability among Iranian community-dwelling older adults.

Methods
In this descriptive and cross-sectional study, 300 older adults were selected using cluster sampling from January to June 2022. The data were collected using the Multidimensional Scale of Perceived Social Support (MSPSS), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2), and the Cohen Perceived Stress Scale-14 (PSS-14). The collected data was analyzed using structural equation modeling (SEM) in Mplus.

Results
The mean age of older adults was 68.71 ± 6.13 years, ranging from 60 to 85 years old. The results of this study revealed a significant relationship between perceived social support and disability (β=-0.20, SE = 0.06, p < 0.001) and perceived stress and disability (β = 0.50, SE = 0.05, p < 0.001). The results also confirmed the mediating role of perceived stress in the relationship between perceived social support and disability (β=-0.17, SE = 0.03, p < 0.001).

Conclusion
The results indicated that increasing social support could reduce disability by decreasing perceived stress. These results have important implications for policymakers and healthcare professionals in promoting healthy aging.