bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study protocol for a three-arm randomized controlled trial investigating the effectiveness, cost-utility, and physiological effects of a fully self-guided digital Acceptance and Commitment Therapy for Spanish patients with fibromyalgia
Authors: Gallego Ana , Serrat Mayte , Royuela-Colomer Estíbaliz , Sanabria-Mazo Juan P , Borràs Xavier , Esteve Montserrat , Grasa Mar , Rosa Araceli , Rozadilla-Sacanell Antoni , Almirall Miriam , D’Amico Francesco , Dai Yifei , Rosenbluth Michael J. , McCracken Lance M. , Navarrete Jaime , Feliu-Soler Albert , Luciano Juan V 
Published: March 2024

Objective Fibromyalgia (FM) is a prevalent pain syndrome with significant healthcare and societal costs. The aim of the SMART-FM-SP study is to determine the effectiveness, cost-utility, and physiological effects in patients with FM of a digital intervention (STANZA®) currently marketed in the United States, which delivers smartphone-based, fully self-guided Acceptance and Commitment Therapy (Digital ACT) for treating FM-related symptoms. Methods A single-site, parallel-group, superiority, randomized controlled trial (RCT) will be conducted, including a total of 360 adults diagnosed with FM. Individuals will be randomly allocated (1:1:1) to treatment as usual (TAU), to TAU plus 12 weeks of treatment with Digital ACT, or to TAU plus 12 weeks of treatment with digital symptom tracking (i.e. FibroST). Participants will be assessed at baseline, post-treatment, and 6-month follow-up. An intention-to-treat analysis using linear mixed models will be computed to analyze the effects of Digital ACT on functional impairment (primary outcome), as measured by the Fibromyalgia Impact Questionnaire Revised at 6 months from the inception of the treatment. Secondary outcomes include impression of change, symptoms of distress, pain catastrophising, quality of life, cost-utility, and selected biomarkers (cortisol and cortisone, immune-inflammatory markers, and FKBP5 gene polymorphisms). The role of ACT-related processes of change will be tested with path analyses. Conclusions This study is the first RCT that tests Digital ACT for Spanish patients with FM. Results will be important not only for patients and clinicians, but also for policy makers by examining the cost-utility of the app in a public healthcare context.
Barriers and challenges to telemedicine usage among the elderly population in Israel in light of the COVID-19 era: A qualitative study
Authors: Haimi Motti , Goren Uri , Grossman Zachi 
Published: March 2024

Background Although there may still be many challenges to its adoption, telemedicine is becoming more and more popular for helping elderly people preserve their independence and continue to live in their own homes. We intended to investigate the challenges and barriers (if any) experienced by the elderly population when using telemedicine services in Israel. Methods Fourteen elderly people were recruited for the study and interviewed in person using a semistructured interview protocol, using a qualitative technique. Participants’ replies were evaluated and analyzed thematically. The participants were questioned regarding their usage of telehealth services, the benefits they perceive in them, any potential difficulties or hurdles to use, and suggestions they had for making these services more readily available and simpler to use for the elderly. Results Most participants recognized the advantages of telehealth services, particularly for the elderly population during pandemics and normal times. However, most of them also expressed various challenges that face the elderly population in using these services. Many participants were concerned that the quality of telemedicine sessions may not be good enough compared to in-person sessions, and expressed a lack of confidence in telemedicine services, and frustration from the absence of in-person interaction and communication. Many participants highlighted the technological challenges in the use of computers and applications in general and in the context of healthcare, in particular, in addition to physiological and literacy difficulties. Finally, the participants suggested several ways to increase the accessibility and usage of telemedicine solutions by elderly people. Conclusions A proactive approach to identifying and resolving telehealth barriers can maximize virtual interactions for the older population and alleviate care inequities. In addition to identifying barriers that impede older patients from using telemedicine, there is a need to increase awareness of the availability, benefits, and uses of each telehealth service in comparison to in-person consultations.
A Qualitative Analysis of Knowledge Levels, Perceived Susceptibility, and Perceived Severity Surrounding Anal Cancer and Human Papillomavirus
Authors: Jovanov Adriana , Parks Ashley , Jovanov Cynthia , Mdluli Xolani 
Published: March 2024

Introduction: When examining health literacy and disease specific knowledge levels across ethnicities and communities, ethnic minority groups are known to be at a higher risk of being below the average health literacy threshold which is a factor linked to poor health status and higher mortality rates. This study examined disease specific knowledge levels, perceived severity, and perceived susceptibility surrounding anal cancer and HPV-related screening behaviors. Methods: The following research questions were explored: (1) “What are the common themes and/or beliefs when asked about anal cancer, HPV, and preventive screening?” and (2) “What are the common themes and beliefs surrounding the severity and susceptibility of contracting anal cancer?”. This study utilized a cross-sectional design to survey 26 individuals regarding their knowledge level and perspectives regarding anal cancer and HPV. An 8-question survey was developed de novo based on an application of the Health Belief Model (HBM) elements. This study employed thematic analysis to explore critical themes to construct a model to understand knowledge levels, attitudes, and risk perceptions regarding anal cancer and intention to participate in preventive screenings. The fundamental attitudes and themes related to anal cancer risk and intention to participate in preventative screenings were elicited using a qualitative descriptive technique. Coded data was utilized to analyze themes based on (1) knowledge and (2) perceived risk, both severity and susceptibility. Results: Overall, the findings indicate very low levels of knowledge regarding screening, anal cancer, and HPV across all genders. The low levels of anal cancer and HPV knowledge were seen in 13 coded segments (50% of surveys) which showed no familiarity with or comprehension of HPV, and 4 coded segments indicated no familiarity with anal cancer. In addition, 15 respondents (57%) had low or no preventive or screening-related knowledge. While some respondents (46%) illustrated high perceived severity for anal cancer, only 23% indicated high perceived susceptibility for anal cancer. Conclusion: The results from this study may be used to inform practitioners, providers, and policymakers in developing interventions addressing low levels of understanding and disease specific knowledge surrounding anal cancer in support of creating a standardized health screening procedure.
Autism and sleep across development: Advancing research and treatment through co-production
Authors: Spanò Goffredina , Combs Dan , Dwyer Patrick , Luongo Alison , Parent-Johnson Wendy , Edgin Jamie 
Published: March 2024

Sleep difficulties are highly prevalent in autistic individuals throughout their lifespan and are a substantial concern for these individuals, as well as parents/caregivers. These difficulties have been exacerbated by the COVID-19 pandemic, and the long-term effects are unclear and should be monitored. Despite considerable progress, sleep disorders continue to be underdiagnosed and left untreated in autistic youth. The sleep issues faced by autistic youth often differ from those experienced by neurotypical groups in presentation and treatment approaches, underscoring the urgent need for autism-specific validated diagnostic pathways as well as personalized treatments tailored to their age group. A step towards progress entails incorporating sleep screenings as a routine part of healthcare for autistic individuals at various developmental stages as sleep issues during childhood may differ from those in adolescence and adulthood. Future research in this area should aim to engage in community-based research partnerships with autistic individuals and parent-caregivers to maximize the benefits of future research for the community. A collaborative effort is necessary to address their distinct sleep hygiene practices and unique needs, which appear to differ from the general population. Through this co-produced commentary, we aim to contribute to the ongoing dialogue surrounding sleep difficulties in autistic youth, fostering a collaborative approach to improve understanding of these disturbances, their diagnosis, and how tailored treatments may be available. Lay Abstract Autistic individuals often face sleep difficulties that persist across their lives, causing concern for those experiencing them and their families/caregivers. The COVID-19 pandemic has heightened these challenges, with unclear long-term effects. Despite progress, sleep disorders in autistic youth are still underdiagnosed and untreated. Their sleep problems may differ from neurotypical peers, emphasizing the need for tailored solutions. Regular sleep screenings and collaborative research partnerships are essential steps in understanding and addressing their unique sleep needs.
Multifaceted experiments and photothermal simulations based analysis of laser induced graphene and its fibers
Authors: Adiraju Anurag , Al-Hamry Ammar , Jalasutram Aditya , Wang Junfei , Kanoun Olfa 
Published: March 2024

AbstractThe interaction of CO2 laser with polyimide results in the formation of laser-induced graphene (LIG) and other morphological transitions based on laser parameters, such as Laser-induced fibers (LIF) on the surface. However, a fundamental investigation of LIF, its properties and potential have not been explored until now. We aim therefore to provide novel insights into the LIF by characterization of its structural, electrical, electrochemical, and mechanical properties. Four different morphologies were identified depending on the laser parameters and the temperature required for their formation were quantified by FEM model. Minimum temperatures of 1800 K were required to form LIG and around 2600 to 5000 K to form LIF. High heterogeneity of the LIF along thickness due to temperature gradients, and the existence of sheet structures underneath the fibers were identified. Due to the loosely bound nature of fibers, LIF dispersion was prepared by ultrasonication to functionalize the carbon electrode for electrochemical characterization. The modification with LIF on the electrodes enhanced the electrochemical response of the electrode towards standard redox couple which confirmed the conductive nature of the fibers. This work provides a solid basis for the versatile tuning of the behavior and properties of LIF for potential applications.
Correlation analysis of angles κ and α with the refraction and anterior segment parameters in children
Authors: Ye Yuhao , Zhao Yu , Zhang Zhe , Wei Ruoyan , Xian Yiyong , Huang Yangyi , Liu Fang , Xu Ye , Zhou Xingtao 
Published: March 2024

Abstract
Aim
To investigate the correlation of angles α and κ with the refractive and biological parameters in children.

Methods
This case-series study included 438 eyes of 219 children (males/females = 105/114, age: 3–15 years). Ocular biometric parameters, including axial length, corneal radius of curvature (CR), white-to-white distance (WTW), angle κ and angle α, were measured using IOL Master 700; auto-refraction were assessed under cycloplegia. The eyes were assigned to different groups based on CR, WTW, and gender to compare the angles α and κ, and analyze the correlations between the differences of biological parameters on angles α and κ.

Results
The means of axial length, CR, WTW, angle α, and angle κ were 23.24 ± 1.14 mm, 7.79 ± 0.27 mm, 11.68 ± 0.41 mm, 0.45 ± 0.25 mm, and 0.27 ± 0.22 mm, respectively. Angle α was correlated with CR and WTW (fixed effect coefficient [FEC] = 0.237, p = 0.015; FEC = -0.109, p = 0.003; respectively), and angle κ also correlated with CR and WTW (FEC = 0.271, p = 0.003; FEC = -0.147, p < 0.001, respectively). Comparing subgroups, the large CR and small WTW group had larger angles α (0.49 ± 0.27 vs. 0.41 ± 0.21, p < 0.001; 0.46 ± 0.27 vs. 0.44 ± 0.21, p < 0.05, respectively) and κ (0.29 ± 0.25 vs. 0.24 ± 0.15, p < 0.01; 0.29 ± 0.25 vs. 0.26 ± 0.19, p < 0.05, respectively). The differences in interocular angles α and κ showed correlation with interocular WTW (r = − 0.255, p < 0.001; r = − 0.385, p < 0.001). Eyes with smaller WTW tended to have larger angle κ (0.28 ± 0.27 vs. 0.25 ± 0.15, p < 0.05).

Conclusion
The size of angle α/κ may be correlated to CR and WTW, and a larger WTW eye may suggest a smaller angle κ compared with the fellow eye.
High Oestrogen receptor alpha expression correlates with adverse prognosis and promotes metastasis in colorectal cancer
Authors: Topi Geriolda , Satapathy Shakti Ranjan , Ghatak Souvik , Hellman Karin , Ek Fredrik , Olsson Roger , Ehrnström Roy , Lydrup Marie-Louise , Sjölander Anita 
Published: March 2024

AbstractIn normal colon tissue, oestrogen receptor alpha (ERα) is expressed at low levels, while oestrogen receptor beta (ERβ) is considered the dominant subtype. However, in colon carcinomas, the ERα/β ratio is often increased, an observation that prompted us to further investigate ERα’s role in colorectal cancer (CRC). Here, we assessed ERα nuclear expression in 351 CRC patients. Among them, 119 exhibited positive ERα nuclear expression, which was significantly higher in cancer tissues than in matched normal tissues. Importantly, patients with positive nuclear ERα expression had a poor prognosis. Furthermore, positive ERα expression correlated with increased levels of the G-protein coupled cysteinyl leukotriene receptor 1 (CysLT1R) and nuclear β-catenin, both known tumour promoters. In mouse models, ERα expression was decreased in Cysltr1−/− CAC (colitis-associated colon cancer) mice but increased in ApcMin/+ mice with wild-type Cysltr1. In cell experiments, an ERα-specific agonist (PPT) increased cell survival via WNT/β-catenin signalling. ERα activation also promoted metastasis in a zebrafish xenograft model by affecting the tight junction proteins ZO-1 and Occludin. Pharmacological blockade or siRNA silencing of ERα limited cell survival and metastasis while restoring tight junction protein expression. In conclusion, these findings highlight the potential of ERα as a prognostic marker for CRC and its role in metastasis.
Mixed boundary value problems involving Sturm–Liouville differential equations with possibly negative coefficients
Authors: Bonanno Gabriele , D’Aguì Giuseppina , Morabito Valeria 
Published: March 2024

AbstractThis paper is devoted to the study of a mixed boundary value problem for a complete Sturm–Liouville equation, where the coefficients can also be negative. In particular, the existence of infinitely many distinct positive solutions to the given problem is obtained by using critical point theory.
Early oral feeding and its impact on postoperative outcomes in head and neck cancer surgery: a meta-analysis
Authors: Dean Yomna E. , Motawea Karam R. , Bamousa Bdoor Ahmed A. , Loayza Pintado Jose J. , Elawady Sameh Samir , Soffar Mohammed , Shah Jaffer , Wilcox Kailyn , Aiash Hani 
Published: March 2024

Abstract
Background
Early oral feeding has been previously postulated to contribute to developing postoperative complications following head and neck reconstructive surgeries using free flaps. This study assessed the association between the timing of oral feeding (early vs. late) and postoperative complications and length of hospital stay among these patients.

Method
PubMed, Scopus, Cochrane, and Web of Science were searched using terms such as “oral feeding” and “head or neck cancer.” We utilized RevMan software version 5.4 for the analysis. The study defined early oral feeding as feeding within 5-day post-operation, while late oral feeding was defined as feeding after the fifth postoperative day. Five papers that met the inclusion criteria were included in the analysis, with 1097 patients.

Results
The results showed that early feeding was not significantly associated with postoperative fistulas (RR 0.49, 95% CI 0.23 to 1.05, p-value = 0.07), hematoma/seroma (RR 0.71, 95% CI 0.33 to 1.51, p-value = 0.38), or flap failure (RR 0.84, 95% CI = 0.38 to 1.87, p-value = 0.67). However, early oral feeding was significantly associated with shorter hospital stays than late oral feeding (MD −3.18, 95% CI −4.90 to −1.46, p-value = 0.0003).

Conclusion
No significant difference exists between early and late oral feeding regarding the risk of postoperative complications in head and neck cancer (HNC) patients who underwent free flap reconstruction surgery. However, early oral feeding is significantly associated with a shorter hospital stay than late oral feeding. Thus, surgeons should consider implementing early oral feeding after free flap reconstruction in HNC patients.
The indigenous bioculture of the Pungalá parish of Ecuador an approach to their culinary and medicinal heritage
Authors: Zurita-Gallegos Ronald Mauricio , Bastidas-Arauz María Belén , Saeteros-Hernandez Angélica María , Herrera Chávez Renato Hernán , Cardenas-Moyano María Yadira 
Published: March 2024

AbstractThe food and culinary heritage with medicinal uses are a fascinating field that combines history, culture, and health through food. Over the centuries, various cultures have developed knowledge and practices related to the use of specific ingredients and culinary preparations with medicinal properties. In the Pungalá parish in Ecuador, these generational knowledge and traditions form a valuable biocultural heritage that helps us understand the close relationship between food and traditional medicine. Through qualitative and documentary research, interviews and community workshops are conducted to gather information using different techniques. Among the findings regarding the food and culinary heritage of Pungalá are extinct culinary traditions, as well as important culinary techniques and processes that play a role in nutrition and medicine, valuing traditional and ancestral knowledge as part of their culture. The inventory includes 22 plants used in Andean medicine and 38 preparations, including beverages, porridges, stews, soups, and wrapped dishes that become an integral part of everyday routines, dietary habits, and festive traditions. It is concluded that this knowledge constitutes a valuable food and culinary heritage, and its biocultural is based on ancestral knowledge of the healing properties of local plants and foods, contributing to the health and identity of the community. Measures should be taken to preserve and promote this heritage in the face of current challenges.
Clinical impact of IDH1 mutations and MGMT methylation in adult glioblastoma
Authors: Mahmoud Magda Sayed , Khalifa Mohamed K. , Nageeb Amira M. , El-Arab Lobna R. Ezz , El-Mahdy Manal , Ramadan Amal , Hashim Maha , Bakr Noha M. , Swellam Menha 
Published: March 2024

Abstract
Background
Impact of Isocitrate dehydrogenase1 (IDH1) and O6-methylguanine-DNA methyltransferase (MGMT) in glioblastoma (GBM) have been of great interest due to their implications in prediction of prognosis of several types of cancer. It was aimed to investigate the clinical role of IDH1 mutation and MGMT methylation pattern among GBM patients versus non-neuro-oncological diseases (NND) patients and their impact on survival criteria.

Methods
Formalin-fixed paraffin-embedded (FFPE) tissue sections of 58 GBM and 20 non-neuro-oncological diseases patients were recruited and IDH1 mutation and MGMT methylation was detected using Cast-PCR technology and Methyl II quantitative PCR approach, respectively. Results were assessed with other clinicopathological criteria and survival patterns.

Results
IDH1 mutation was detected among 15 GBM cases (15/58) and it was not reported among NND (P = 0.011). Receiver operating characteristic (ROC) curve was plotted to discriminate between MGMT methylation among studied groups. Patients with MGMT methylation ≥ 66% were reported as high methylation, which was recorded significantly in 51.7% and 100% of GBM cases and NND, respectively. Both showed significant difference with performance status, while MGMT methylation was significantly related with tumor size and tumor location. IDH1 mutation and MGMT methylation reported significant increase with GB patients revealed complete response to treatment. Survival pattern was better for IDH1 mutation and MGMT high methylation as compared to IDH1 wild type or MGMT low–moderate methylation, respectively, and favorable survival was detected when both were combined than using either of them alone.

Conclusion
Detection of IDH1 mutation and MGMT methylation among GB patients could aid in prediction of their response to treatment and their survival patterns, and their combination is better than using any of them alone.
Assessment of hyaluronic acid in COPD patients as a prognostic biomarker
Authors: Elnaggar Marwa Elsayed , Okab Ali Ali , Kamel Mohammed Hussein , Noureldin Amira Mohammed , Abdelhafez Doaa Adel , Osman Maha Mammdouh 
Published: March 2024

Abstract
Background
One essential element of the extracellular matrix is hyaluronic acid (HA). It has been claimed that HA and its metabolism are different in the lungs of patients with chronic obstructive pulmonary disease (COPD). The present study investigated the predictive significance of serum level of HA in patients with COPD and monitored changes in its level in these patients because of therapy.

Methods
HA was assessed in 60 patients with stable COPD (divided into subgroups I and II) and 20 healthy controls and then repeated after 3 and 6 months in COPD patients.

Results
Most of the patients were males (63.3%), and their ages ranged from 30 to 90. The serum level of HA was significantly increased in subgroups I and II (269.33 ± 4, 290 ± 4, respectively), compared to the control group (147.5 ± 1) with a significant difference in its level between both (p < 0.0001). The serum level of HA was significantly decreased in both subgroups 3 and 6 months later following adjustment of treatment and associated with improvement in pulmonary function test. There were significant positive correlations between HA and age as well as smoking index. Its level correlated negatively with forced expiratory volume in the first second (FEV1%), forced vital capacity (FVC%), and FEV1/FVC.

Conclusions
HA is a useful marker for identifying clinical stability in COPD patients and for follow-up in the efficacy of treatment.