bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing the endo-activity of the thermophilic chitinase to yield chitooligosaccharides with high degrees of polymerization
Authors: Guan Feifei , Tian Xiaoqian , Zhang Ruohan , Zhang Yan , Wu Ningfeng , Sun Jilu , Zhang Honglian , Tu Tao , Luo Huiying , Yao Bin , Tian Jian , Huang Huoqing 
Published: March 2024

AbstractThermophilic endo-chitinases are essential for production of highly polymerized chitooligosaccharides, which are advantageous for plant immunity, animal nutrition and health. However, thermophilic endo-chitinases are scarce and the transformation from exo- to endo-activity of chitinases is still a challenging problem. In this study, to enhance the endo-activity of the thermophilic chitinase Chi304, we proposed two approaches for rational design based on comprehensive structural and evolutionary analyses. Four effective single-point mutants were identified among 28 designed mutations. The ratio of (GlcNAc)3 to (GlcNAc)2 quantity (DP3/2) in the hydrolysates of the four single-point mutants undertaking colloidal chitin degradation were 1.89, 1.65, 1.24, and 1.38 times that of Chi304, respectively. When combining to double-point mutants, the DP3/2 proportions produced by F79A/W140R, F79A/M264L, F79A/W272R, and M264L/W272R were 2.06, 1.67, 1.82, and 1.86 times that of Chi304 and all four double-point mutants exhibited enhanced endo-activity. When applied to produce chitooligosaccharides (DP ≥ 3), F79A/W140R accumulated the most (GlcNAc)4, while M264L/W272R was the best to produce (GlcNAc)3, which was 2.28 times that of Chi304. The two mutants had exposed shallower substrate-binding pockets and stronger binding abilities to shape the substrate. Overall, this research offers a practical approach to altering the cutting pattern of a chitinase to generate functional chitooligosaccharides.
Graphical abstract
Child-eating behaviour as predictor of anthropometric status of preschool children aged 2–4 years in Umuahia South LGA Abia State, Nigeria
Authors: Okorie Ijioma , Nwofia Blessing K. , Ngonadi Chinaza , Okorie Adaeze C. , Nnam Ngozi M. 
Published: March 2024

Abstract
Introduction and objective
Eating behaviour at the childhood level plays a vital role in the outcome of the nutritional status and the overall health of an individual. The study was focused on the association between anthropometric status and child eating behaviour.

Methodology
A community-based cross-sectional survey purposively enrolled consenting participants from 256 households with preschool children aged 2–4 years. The parents/legal guardians were interviewed on the eating behaviour of their children using a validated semi-structured child-eating behaviour scale, and anthropometric measurement of the children were taken. WHO Anthro-software for child growth standards was used to categorize anthropometric status of the preschool children. Paired sample t-test was performed to compare child-eating behaviour by gender, while regression and correlation analysis was performed to determine the extent to which child-eating behaviour predicted anthropometric status at 5% level of significance.

Results
Mean comparison of child eating behaviour by gender showed significant difference (P < 0.05) between male and female children in their eating behaviour with respect to enjoyment of food and satiety responsiveness. Some of the children were wasted (26.6%), stunted (20.7%) and underweight (16.4%). A significant association (P < 0.05) was observed between body mass index-for-age and food fussiness behaviour of the children. There was also a significant difference (P < 0.05) between weight-for-age and food fussiness behaviour of the children.

Conclusion
The study showed that child eating behaviour may have contributed to the anthropometric status of the children, however, differences in their eating behaviours by gender was observed.
Assessment of the Surgical Oncology Case Volume Within the Public Sector in Tanzania
Authors: Brand Nathan R. , Akoko Larry , Kotecha Vihar , Mwakyembe Theresia , Mwashambwa Masumbuko , Hamid Rukia , Hando Deo , Komba Charles , Mwanga Ally , Mbele Peter , Itule Paul , Jackson Joshua , Misidai Mungeni , Gaskill Cameron , Ozgediz Doruk 
Published: March 2024

PURPOSE Surgery provides vital services to diagnose, treat, and palliate patients suffering from malignancies. However, despite its importance, there is little information on the delivery of surgical oncology services in Tanzania. METHODS Operative logbooks were reviewed at all national referral hospitals that offer surgery, all zonal referral hospitals in Mainland Tanganyika and Zanzibar, and a convenience sampling of regional referral hospitals in 2022. Cancer cases were identified by postoperative diagnosis and deidentified data were abstracted for each cancer surgery. The proportion of the procedures conducted for patients with cancer and the total number of cancer surgeries done within the public sector were calculated and compared with a previously published estimate of the surgical oncology need for the country. RESULTS In total, 69,195 operations were reviewed at 10 hospitals, including two national referral hospitals, five zonal referral hospitals, and three regional referral hospitals. Of the cases reviewed, 4,248 (6.1%) were for the treatment of cancer. We estimate that 4,938 cancer surgeries occurred in the public sector in Tanzania accounting for operations conducted at hospitals not included in our study. Prostate, breast, head and neck, esophageal, and bladder cancers were the five most common diagnoses. Although 387 (83%) of all breast cancer procedures were done with curative intent, 506 (87%) of patients with prostate and 273 (81%) of patients with esophageal cancer underwent palliative surgery. CONCLUSION In this comprehensive assessment of surgical oncology service delivery in Tanzania, we identified 4,248 cancer surgeries and estimate that 4,938 likely occurred in 2022. This represents only 25% of the estimated 19,726 cancer surgeries that are annually needed in Tanzania. These results highlight the need to identify strategies for increasing surgical oncology capacity in the country.
B-Cell–Mediated Immunity Predicts Survival of Patients With Estrogen Receptor–Positive Breast Cancer
Authors: Lee Seungbok , Kang Byung-Hee , Lee Han-Byoel , Jang Bum-Sup , Han Wonshik , Kim In Ah 
Published: March 2024

PURPOSE The estrogen receptor–positive (ER+) breast cancer (BC), which constitutes the majority of BC cases, exhibits highly heterogeneous clinical behavior. To aid precision treatments, we aimed to find molecular subtypes of ER+ BC representing the tumor microenvironment and prognosis. METHODS We analyzed RNA-seq data of 113 patients with BC and classified them according to the PAM50 intrinsic subtypes using gene expression profiles. Among them, we further focused on 44 patients with luminal-type (ER+) BC for subclassification. The Cancer Genome Atlas (TCGA) data of patients with BC were used as a validation data set to verify the new classification. We estimated the immune cell composition using CIBERSORT and further analyzed its association with clinical or molecular parameters. RESULTS Principal component analysis clearly divided the patients into two subgroups separately from the luminal A and B classification. The top differentially expressed genes between the subgroups were distinctly characterized by immunoglobulin and B-cell–related genes. We could also cluster a separate cohort of patients with luminal-type BC from TCGA into two subgroups on the basis of the expression of a B-cell–specific gene set, and patients who were predicted to have high B-cell immune activity had better prognoses than other patients. CONCLUSION Our transcriptomic approach emphasize a molecular phenotype of B-cell immunity in ER+ BC that may help to predict disease prognosis. Although further researches are required, B-cell immunity for patients with ER+ BC may be helpful for identifying patients who are good responders to chemotherapy or immunotherapy.
Microsurgical Resection of a Lateral Pontine Arteriovenous Malformation Masquerading as a Cavernous Malformation: 2-Dimensional Operative Video
Authors: Graffeo Christopher S. , Scherschinski Lea , Baranoski Jacob F. , Srinivasan Visish M. , Lawton Michael T. 
Published: March 2024

Although cavernous malformations (CMs) often demonstrate characteristic T2 heterogeneity and gadolinium enhancement, whereas arteriovenous malformations (AVMs) appear as tangles of T2 hypointense flow voids, small lesions in deep locations may have equivocal features on preoperative imaging.
1-4
This video presents an unusual case of a lateral pontine AVM masquerading as a CM. The patient presented with sudden-onset headache, dizziness, double vision, and left facial numbness. Diagnostic imaging findings suggested a hemorrhagic left lateral pontine mass lesion, most consistent with brainstem CM. Resection through a left extended retrosigmoid craniotomy was recommended. Patient consent was obtained. During dissection, a prominent petrosal vein tributary was noted to be arterialized, which was concerning for AVM. Indocyanine green videoangiography (ICG-VA) was performed to confirm the diagnosis, and the intraoperative plan was dynamically adjusted in accordance with the principles of AVM resection. The small superficial feeding arteries were identified and disconnected, and the nidus was dissected circumferentially with the pial resection technique. After dearterialization, the draining petrosal vein was noted to darken, and repeat ICG-VA confirmed complete occlusion of the AVM without residual shunting. The patient recovered well, with no neurological deficits, and postoperative angiography confirmed complete resection of the Spetzler-Martin grade III AVM. Key learning points for this unusual case include the importance of dynamic interpretation of intraoperative findings, openness to alterations of the surgical plan when integrating new diagnostic information, and the integration of ICG-VA as a critical tool for differentiating CMs and AVMs during microsurgical resection.
Images in Surgical Video © 2024 Barrow Neurological Institute. Used with permission.
Sex matters in preclinical research
Authors: Justice Monica J. 
Published: March 2024

ABSTRACT
International Women's Day 2024 has a theme of inclusion. As publishers of preclinical research, we aim to show how inclusion of females in research advances scientific rigor and improves treatment reliability. Sexual reproduction is key to all life across the plant and animal kingdoms. Biological sex takes many forms that are morphologically differentiated during development: stamens versus pistils in plants; color and plumage in birds; fallopian tubes versus vas deferens in mammals; and differences in size, for instance, males are smaller in the fruit fly Drosophila melanogaster. Physical differences may be obvious, but many traits may be more obscure, including hormonal, physiological and metabolic factors. These traits have a big influence on disease and responses to treatment. Thus, we call for improved inclusion, analysis and reporting of sex as a biological variable in preclinical animal modeling research.
Understanding compassionate leadership
Authors: Thomas Vinice 
Published: March 2024

In a culture of compassion and care, the benefits to the individual and the organisation are vast—these include: creating a positive working environment; staff wellbeing; high morale; engaged workforce; and commitment to the organisation. All these factors will ultimately lead to a high quality of care for patients, and a better patient experience and outcomes. The challenges faced by society and the workforce today heighten our need for compassionate leaders across health and social care. A compassionate leader is an individual who embodies care, kindness, consideration, wisdom and integrity in their treatment of themselves and others. The article looks at compassionate leadership—its definition, characteristics, and traits. While the benefits are well documented in the literature, this article discusses the challenges that compassionate leaders may encounter and how best to support their development accordingly. The importance of self-awareness and self-care is vital to sustain the energy levels and effectiveness of the compassionate leader. Compassionate leadership has the ability to make individuals feel supported, valued and dignified. It is the author's view that it is one of the most important leadership styles within 21st century health care.
Diagnosis of human brucellosis: Systematic review and meta-analysis
Authors: Freire Mariana Lourenço , Machado de Assis Tália Santana , Silva Sarah Nascimento , Cota Gláucia 
Published: March 2024

Background
Brucellosis, a widely spread zoonotic disease, poses significant diagnostic challenges due to its non-specific symptoms and underreporting. Timely and accurate diagnosis is crucial for effective patient management and public health control. However, a comprehensive comparative review of available diagnostic tests is lacking.

Methodology/Principal findings
This systematic review addressed the following question: ‘What is the accuracy of the available tests to confirm human brucellosis?’ Two independent reviewers examined articles published up to January 2023. The review included original studies reporting symptomatic patients with brucellosis suspicion, through any index test, with sensitivity and/or specificity as outcomes. As exclusion criteria were considered: sample size smaller than 10 patients, studies focusing on complicated brucellosis, and those lacking essential information about index or comparator tests. Sensitivity and specificity were assessed, with consideration for the index test, and ‘culture’ and ‘culture and standard tube agglutination test (SAT)’ were used as reference standards. Bias assessment and certainty of evidence were carried out using the QUADAS-2 and GRADE tools, respectively. A total of 38 studies reporting diagnostic test performance for human brucellosis were included. However, the evidence available is limited, and significant variability was observed among studies. Regarding the reference test, culture and/or SAT are deemed more appropriate than culture alone. Rose Bengal, IgG/IgM ELISA, and PCR exhibited equally high performances, indicating superior overall diagnostic accuracy, with very low certainty of the evidence.

Conclusions/Significance
This systematic review underscores the potential of the Rose Bengal test, IgG/IgM ELISA, and PCR as promising diagnostic tools for brucellosis. However, the successful implementation and recommendations for their use should consider the local context and available resources. The findings highlight the pressing need for standardization, improved reporting, and ongoing advancements in test development to enhance the accuracy and accessibility of brucellosis diagnosis.
Clinical nurse managers’ leadership styles and staff nurses’ work engagement in Saudi Arabia: A cross-sectional study
Authors: Alluhaybi Amal , Usher Kim , Durkin Joanne , Wilson Amanda 
Published: March 2024

Background
Effective nurse leadership enhances nurse welfare, improves patient care, and increases organisational success. A lack of adequate, supportive leadership significantly contributes to many nurses leaving the profession. Nurse managers need to prioritise engagement and retention as significant focus areas to address the nursing shortage in Saudi Arabia and accomplish the national program’s objectives.

Aim
To examine the correlation between the leadership styles of clinical nurse managers and staff engagement.

Method
This study used a descriptive, cross-sectional, correlational design. The leadership styles of clinical nurse managers were evaluated using the Multifactor Leadership Questionnaire (MLQ-5X). Work engagement was assessed using the Utrecht Work Engagement Scale (UWES). Questionnaires were distributed to 450 nurses in four public hospitals in western Saudi Arabia. Non-probability convenience sampling was used to collect the data.

Results
A total of 278 nurses from a range of clinical areas participated in the survey, which revealed that the leadership styles of clinical nurse managers positively or negatively impact nurse work engagement. Most clinical nurse managers exhibit transformational leadership, followed by transactional, then passive-avoidant styles. Respondents displayed a high level of work engagement, emphasising the positive impact of transformational and transactional leadership on work engagement outcomes. The findings showed significant differences in leadership styles and work engagement levels between Saudi and non-Saudi nurses across various dimensions.

Conclusion
Understanding the effect of leadership styles employed by nurse managers on work engagement can positively impact staff retention rates and the quality of patient care. Nurse managers should participate in training programs to enhance their practical leadership skills to enhance the work engagement levels of nurses.

Implication
Nurse work engagement can be improved by establishing training programs that promote effective leadership and highlight the significance of various leadership styles and their subsequent impact on nurse work engagement. Nursing students should receive education on leadership styles. Nursing leaders should be given access to mentoring programs and opportunities for career advancement to support the introduction of effective leadership styles.
Understanding uptake of COVID-19 testing, vaccination, and boosters among Spanish-speaking Latines in the United States: Qualitative insights from Spanish speakers and key informants
Authors: Tanner Amanda E. , Hall Mark A. , Aguilar-Palma Sandy K. , Mann-Jackson Lilli , Alonzo Jorge , Bertoni Alain G. , McCoy Thomas P. , Garcia Manuel , Sucaldito Ana D. , Turner Mari Jo , Robles Arvizu Jose , Russell Laurie P. , Rhodes Scott D. 
Published: March 2024

Background
Latine communities in the United States have been disproportionately affected by COVID-19. It is critical to gain a better understanding of the sociocultural determinants that challenge and facilitate COVID-19 testing, vaccination, and booster uptake within these vulnerable communities to inform culturally congruent strategies and interventions.

Methods
In summer 2022, our community-based participatory research partnership conducted 30 key informant interviews and 7 focus groups with 64 Spanish-speaking Latine participants in North Carolina. Interviewees consisted of representatives from health and service organizations, most of whom were engaged with direct service to Spanish speakers. Interviews were conducted in either English or Spanish, depending on the preference of the participant; all focus groups were conducted in Spanish. Interviews and focus groups were conducted in person or by videoconference.

Results
Twenty themes emerged that we organize into four domains: general perceptions about COVID-19; barriers to COVID-19 testing, vaccination, and booster uptake; facilitators to COVID-19 testing, vaccination, and booster uptake; and recommendations to promote testing, vaccination, and booster uptake.

Discussion
Results underscore important sociocultural determinants of ongoing COVID-19 testing, vaccination, and booster uptake to consider in developing interventions for Spanish-speaking Latines in the United States. Based on this formative work, our partnership developed Nuestra Comunidad Saludable (Our Healthy Community). We are implementing the intervention to test whether trained peer navigators can increase COVID-19 testing, vaccination, and booster uptake among Spanish-speaking Latines through blending in-person interactions and mHealth (mobile health) strategies using social media.
Analysis of prognosis and background liver disease in non-advanced hepatocellular carcinoma in two decades
Authors: Kaneko Shun , Asahina Yasuhiro , Murakawa Miyako , Azuma Seishin , Inada Kento , Mochida Tomohiro , Watakabe Keiya , Shimizu Taro , Tsuchiya Jun , Miyoshi Masato , Kawai-Kitahata Fukiko , Nitta Sayuri , Takahashi Marie , Fujioka Tomoyuki , Kishino Mitsuhiro , Anzai Tatsuhiko , Kakinuma Sei , Nakagawa Mina , Okamoto Ryuichi 
Published: March 2024

Background/Aim
Antiviral hepatitis and systemic therapies for hepatocellular carcinoma (HCC) remarkably progressed in the recent 10 years. This study aimed to reveal the actual transition and changes in the prognosis and background liver disease in non-advanced HCC in the past 20 years.

Methods
This retrospectively recruited 566 patients who were diagnosed with non-advanced HCC from February 2002 to February 2022. The prognosis was analyzed by subdividing according to the diagnosis date (period I: February 2002–April 2009 and period Ⅱ: May 2009–February 2022).

Results
Patients in period II (n = 351) were significantly older, with lower albumin-bilirubin (ALBI) scores and alpha-fetoprotein (AFP) and more anti-viral therapy, systemic therapy, and hepatic arterial infusion chemotherapy as compared with those in period I (n = 215). The etiology ratio of the background liver disease revealed decreased hepatitis C virus from 70.6% to 49.0% and increased non-B, non-C from 17.7% to 39.9% from periods I to Ⅱ. The multivariate analysis revealed older age and higher ALBI score in Barcelona Clinic Liver Cancer (BCLC) 0/A stage, AFP of >20 ng/mL, and higher ALBI score in BCLC B stage as independent prognosis factors. Fine-Gray competing risk model analysis revealed that liver-related deaths significantly decreased in period II as compared to period I, especially for BCLC stage 0/A (HR: 0.656; 95%CI: 0.442–0.972, P = 0.036).

Conclusion
The characteristics of patients with non-advanced HCC have changed over time. Appropriate background liver management led to better liver-related prognoses in BCLC 0/A.
Pain management after tonsil surgery in children and adults—A national survey related to pain outcome measures from the Swedish Quality Register for tonsil surgery
Authors: Roskvist Maria , Alm Fredrik , Nerfeldt Pia , Ericsson Elisabeth 
Published: March 2024

Objective
The primary aim of this study was to describe the current practice regarding pain management in relation to tonsil surgery among Ear Nose and Throat (ENT) clinics in Sweden. The secondary aim was to determine the impact of the provider’s regime of rescue analgesics on the pain related Patient Reported Outcome Measures (pain-PROMs) from the Swedish Quality Register for Tonsil Surgery (SQTS).

Materials & methods
A descriptive cross-sectional study originating from a validated web-based questionnaire. The survey enrolled one respondent from each ENT clinic (47/48 participated) nationally. Pain-PROMs from the SQTS, recorded from October 2019 to October 2022, were included (8163 tonsil surgeries).

Results
Paracetamol was used by all enrolled ENT clinics as preemptive analgesia. The addition of COX inhibitors was used in 40% of the clinics. Betamethasone was usually administered, to prevent pain and nausea (92%). All clinics gave postdischarge instructions on multimodal analgesia with COX inhibitors and paracetamol. Rescue analgesics were prescribed after tonsillectomy for 77% of adults, 62% of older children, 43% of young children and less often after tonsillotomy. The most frequently prescribed rescue analgesic was clonidine in children (55%) and oxycodone in adults (72%).
A high proportion of patients reported contact with health care services due to postoperative pain (pain-PROMs/ SQTS). Tonsillectomy procedures were associated with the highest rates of contacts (children/adolescents 13–15%; adults 26%), while tonsillotomy were associated with lower rates, (5–7% of children/adolescents). There was no significant difference in the frequency of health care contacts due to pain regarding whether clinics routinely prescribed rescue analgesics or not after tonsillectomy.

Conclusion
The Swedish analgesic regimen after tonsil surgery is good overall. Nevertheless, there is a need for increased awareness and knowledge to achieve optimal patient recovery. Pain-PROM data demonstrate the call for improvement in pain management after tonsil surgery.