bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detailed statistical analysis plan for a guided self-determination intervention versus an attention control for outpatients with type 2 diabetes in the randomised OVERCOME trial.
Authors: Mathiesen Anne Sophie , Zoffmann Vibeke , Lindschou Jane , Jakobsen Janus Christian , Gluud Christian , Olsen Markus Harboe , Rasmussen Bodil , Marqvorsen Emilie Haarslev Schröder , Rothmann Mette Juel 
Published: April 2024

Abstract

Background
Autonomy-supporting interventions may be a prerequisite to achieve better long-term management of type 2 diabetes. Evidence suggest that the guided self-determination (GSD) method might improve haemoglobin A1c and diabetes distress in people with type 1 diabetes. The evidence of an effect of a GSD intervention compared with an attention control group in adults with type 2 diabetes is unknown.
Methods/design
The trial is designed as a pragmatic, investigator-initiated, dual-centre, randomised, parallel-group, assessor-blinded, superiority clinical trial of persons with type 2 diabetes. A nurse will administer GSD intervention versus an attention control. The primary outcome is diabetes distress, and secondary outcomes are quality of life, depressive symptoms, and non-serious adverse events. Exploratory outcomes are haemoglobin A1c, motivation, and serious adverse events. Participants are assessed at baseline, 5-, and 12-months follow-up. Here, we present a detailed, comprehensive plan of all statistical analyses, including methods to handle missing data, and assessments of the underlying statistical assumptions. The statistical analyses will be conducted independently by two statisticians following the present plan.
Discussion
To mitigate the risk of analysis bias and increase the validity of the OVEROME trial, this statistical analysis plan was developed prior to unblinding of the trial results in concordance with the Declaration of Helsinki and the Conference on Harmonization of Good Clinical Practice Guidelines.
Trial registration
ClinicalTrials.gov NCT 04601311, October 2020.
Evaluation of a Health Promotion Program Based on Community-Based Participatory Research for Older Adults at Risk for Metabolic Syndrome
Authors: Yang Juhyeon , Park Bohyun 
Published: April 2024

Abstract
Background
This study aimed to evaluate the effects of a health promotion program developed using Community-Based Participatory Research (CBPR) for older adults at risk for developing metabolic syndrome in rural areas.
Methods
The methodology of this study is a mixed method using embedded design. A non-random controlled trial (26 in the experimental group and 16 in the control group) for the quantitative study and a qualitative content analysis for the qualitative study were used.
Results
After the health promotion program, health promotion behavior (exercise and physical activity, cognitive maintenance function, positive acceptance) and physiological indicators related to metabolic syndrome (fast blood sugar, triglyceride, and body mass index) were significantly improved. At the intrapersonal level, positive changes regarding participants’ bodies, daily life, and emotional satisfaction were noted. At the interpersonal level, participants’ social support and sense of community improved.
Conclusions
This health promotion program was based on the Social Ecological Model and was developed using CBPR. Changes in some indicators at the individual and interpersonal levels were identified through the quantitative study, while specific changes at the individual, interpersonal, and community levels were identified in the qualitative study. Manuals and an assessment tool must be developed to encourage wider use of CBPR.
Community-Acquired Infections by Highly Virulent Acinetobacter Pittii: A Study of Molecular Characteristics and Literature Review
Authors: sun Jian , Xu Wenzeng , Zhan Xiaoying , Tian Xin , Yu Yunsong 
Published: April 2024

Abstract

Background: Acinetobacter Pittii, a Gram-negative bacterium, is widely prevalent in the natural environment. It is a non-fermentative bacterium commonly found in various settings such as soil, water, and healthcare facilities. Furthermore, Acinetobacter Pittii can also colonize the skin, respiratory tract, and digestive tract of both humans and animals. Historically, Acinetobacter Pittii has been recognized as a nosocomial pathogen, exhibiting multidrug resistance that presents a significant challenge in the healthcare field. However, instances of community-acquired infections, particularly severe infections, have been relatively limited. This article presents a case study of severe pneumonia and septic shock caused by a highly virulent community-acquired strain of Acinetobacter Pittii. The patient also developed multiple lung nodules and cavities, further highlighting the pathogenicity of this strain. The study delves into the treatment regimen employed, as well as the virulence and molecular characteristics of this particular strain.
Case presentation: Report of the case of community-acquired human pulmonary infection caused by Acinetobacter Pittii.
Conclusions: Community-acquired Acinetobacter Pittii, characterized by its high virulence and intense inflammatory response, can lead to severe infections, resulting in septic shock, disease progression, and the potential development of Pulmonary nodules and cavities. Clinical physicians should give due attention to this condition.
Comparison of screening results of urban cancer early diagnosis and early treatment project in 2023 and 2022 in Wuwei City
Authors: Sun Qian , Hu Junguo , Cai Qinghua , Ye Yancheng , Lu Linzhi , Huang Yue , Wang Hongzong , Liu Xiaxia , Ma Li , Zhang Xiaoqian , Yang Rui 
Published: April 2024

Abstract

Objective
To compare the screening results of urban cancer early diagnosis and early treatment project in Liangzhou District of Wuwei City in 2023 and 2022, analyze the characteristics of screening population changes, and provide optimization suggestions for the future development of urban cancer project.
Methods
The 2022–2023 screening data were extracted from the urban cancer screening system and matched with the telephone follow-up results of the cancer population, and the characteristics of the two-year screening population were compared by gender and age. Chi-square test was used for comparison between groups.
Results
From 2022 to 2023, a total of 6098 people participated in questionnaire assessment and 4400 people participated in clinical screening. In 2023, 1587 people were at high risk, with a high risk rate of 92.61%; In 2022, 3301 people are at high risk, with a high risk rate of 80.06%. The two-year data comparison found that both the overall risk rate comparison and the gender comparison, the risk rate in 2023 was higher than that in 2022. However, by age group comparison, it is found that in 2022, the middle age group has a higher risk rate, and in 2023, the high age group has a higher risk rate. In 2023, 1,975 people will participate in assessment and 1,560 people will participate in clinical screening. The participation rate of clinical screening was 78.99%. In 2023, 36.35% men and 63.65% women will participate in clinical screening. In 2022, 33.06% of men and 66.94% of women participated in clinical screening. The sex composition ratio of the population participating in clinical screening at two years was similar. The proportion of people participating in clinical screening in 2022 and 2023 was compared by age group, and it was found that the three age groups of 50–64 years old accounted for the largest number of people, and the 70–74 years old group accounted for the least. Compared with 2022, the detection rate of cancer in all parts of 2023 has decreased, and the detection rate of other positive lesions besides cancer in liver, breast, colorectal and upper digestive tract has also decreased, but the detection rate of other positive lesions besides cancer in lung has increased by 17.98%.
Conclusion
There is still room for improvement in the participation rate of clinical screening, and more measures should be taken to encourage high-risk groups to complete clinical screening programs. In addition, the ability to detect diseases in staff still needs to be improved.
Course of inflammation and infection markers differ in ICU patients with severe COVID-19 under casirivimab- and/or tocilizumab application: an observational study
Authors: Iustila-Maran Stana-Nicoleta , Orlet Amelie , Traeger Karl , Weiss Manfred 
Published: April 2024

Abstract

Background: The outcome and longitudinal course of inflammation and infection markers were unknown in COVID-19 patients on the ICU treated without (N) or with SARS-CoV-2 specific monoclonal antibodies (casirivimab / imdevimab, C) or antibodies against interleukin-6 (IL-6) receptors (tocilizumab, T), solely, or in combination of both (C + T).
Methods: In a retrospective observational study, in critically ill N, C, T, C+ T COVID-19 patients admitted to the ICU with the CoV-2 delta-variant between August 2021 and February 2022, 28-day mortality and 30-day time course of infection and inflammation markers were evaluated.
Results: Out of 95 patients with COVID-19, 29 patients were not treated (N), 17 with C, 16 with T, 33 with C + T. Mortality rates in N, C, T, and C + T, were 24%, 35%, 56%, and 24%, being higher in T compared to N and C + T (p = 0.05). Prolonged leukocyte, procalcitonin (PCT), C-reactive protein (CRP) and interleukin 6 (IL-6) elevations were detected in nonsurvivors compared to survivors in C + T within the first two weeks, IL-6 in the first days in T. In N, higher PCT, CRP, IL-6 and ferritin occured in nonsurvivors in the first days.
Conclusion: Sporadically measured IL-6 and CRP in T is less useful. Longlasting IL-6 receptor blockade may be deleterious in COVID-19. High IL-6 may hint at poor prognosis within the first days in T, leukocytes, PCT, CRP and IL-6 in the first two weeks in C + T, and PCT, CRP, IL-6 and ferritin within the first days in N.
Trial registration: ClinicalTrials.gov Identifier: NCT06233357, retrospectively registered, release date: January 31, 2024.
Filbertone-Induced Nrf2 Activation Ameliorates Neuronal Damage via Increasing BDNF Expression
Authors: Gong Jeong Heon , Kim Chu-Sook , Park Jeongmin , Kang So Eon , Jang Yumi , Kim Min-Seon , Chung Hun Taeg , Joe Yeonsoo , Yu Rina 
Published: April 2024

Abstract
Neurotrophic factors are endogenous proteins that promote the survival of various neuronal cells. Increasing evidence has suggested a key role for brain-derived neurotrophic factor (BDNF) in the dopaminergic neurotoxicity associated with Parkinson’s Disease (PD). This study explores the therapeutic potential of filbertone, a bioactive compound found in hazelnuts, in neurodegeneration, focusing on its effects on neurotrophic factors and the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. In our study, filbertone markedly elevated the expression of neurotrophic factors, including Brain-Derived Neurotrophic Factor (BDNF), Glial cell line-Derived Neurotrophic Factor (GDNF), and Nerve Growth Factor (NGF), in human neuroblastoma SH-SY5Y cells, mouse astrocyte C8-D1A cells, and mouse hypothalamus mHypoE-N1 cells. Moreover, filbertone effectively countered neuroinflammation and reversed the decline in neurotrophic factors and Nrf2 activation induced by a high-fat diet (HFD) in neurodegeneration models. The neuroprotective effects of filbertone were further validated in models of neurotoxicity induced by palmitic acid (PA) and the neurotoxin MPTP/MPP+, where it was observed to counteract PA and MPTP/MPP+-induced decreases in cell viability and neuroinflammation, primarily through the activation of Nrf2 and the subsequent upregulation of BDNF and heme oxygenase-1 expression. Nrf2 deficiency negated the neuroprotective effects of filbertone in MPTP-treated mice. Consequently, our finding suggests that filbertone is a novel therapeutic agent for neurodegenerative diseases, enhancing neuronal resilience through the Nrf2 signaling pathway and upregulation of neurotrophic factors.
Changes in primary healthcare workforce burnout during and after the termination of COVID-19 emergency response: a one and half year observational study
Authors: Xueji Wu , Huihong Ruan , Xiaoying Feng , Chaojun Xie , O'Donnell Ronald R. , Zhoubin Zhang 
Published: April 2024

Abstract

Background Primary healthcare workforce (PHCW) should be suffered from less burnout after the termination of the COVID-19 response. The current study compared the changes in the three dimensions of burnout in PHCW during and after the response.
Methods Two convenience-sampling, online, cross-sectional questionnaire studies were conducted in local PHCW. Studies were administered in April, 2022 and eight months after the termination. Burnout was measured by the Chinese version of 15-item Maslach Burnout Inventory-General Survey (MBI-GS), which assesses three dimensions: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (reduced PA). The primary outcome was the prevalence of its three dimensions. Data on demographics, work environment, health conditions and outlets for stress reduction were collected. We compared burnout and associated factors between the study periods by using Student’s t-, chi-, or Mann‒Whitney tests. The associations between factors and burnout was identified by a logistic regression model.
Results In total, 162 and 200 participants completed the questionnairesduring and after the response. No significant differences in demographics, including age, gender, education attainment, work experience or seniority level were observed. The prevalence of burnout-free status was similar (9.9% vs. 12.5%, P=0.434) between thetwo periods. Severe burnout decreasedfrom 45.7% to zero%, and moderate burnout nearly doubled after the response. The prevalence of EE decreased the most, by 55.0%, followed by that of DP, which decreased by38.4% (all P<0.001); however, there wasno difference in the prevalence of reduced PA (77.2% vs. 74.5%, P=0.557). Logistic regression showed thatpromotion and alcohol consumption decreased the risk of EE. Considering leaving the job increases the risk of DP. A lowerself-evaluated health score and more distress were associated with EE and DP. Exercise decreased the risk of reduced PA.
Conclusions Inconsistent with hypothesis, we found that severe burnout decreased but moderate burnout increased in PHCWs after the response. EE and DP decreased more, but reduced PA had no change. Incentives, improved self-evaluated health conditions, alcohol consumption and exercise ameliorate burnout. Healthcare policy makers must consider multiple effective ways to mitigate burnout in the post-epidemic era.
Clustering Fusion Algorithm for ImprovedAccuracy in UWB Indoor Positioning
Authors: Guo Hua , Yin Haozhou , Song Shanshan , Zhu Xiuwei , Ren Daokuan 
Published: April 2024

Abstract
Due to the presence of non-line-of-sight (NLOS) obstacles, the localization accuracy in ultra-wideband (UWB) wireless indoor localization systems is typically substantially lower. To minimize the influence of these environmental factors and improve the accuracy of indoor wireless positioning, a novel fusion optimization algorithm is proposed in this paper, which combines the density-based spatial clustering algorithm with noise (DBSCAN) and particle swarm optimization (PSO) algorithm. The positioning error of this algorithm remains is stable within 3 cm in static positioning scenarios, and can achieve high accuracy in NLOS environments.
Experimental study on the engineering characteristics of include-straight double-row piles at the edge of the embankment
Authors: Feng Chenxi , Feng Yong-guang , Zhou Kun-hong , Chen Kun , Yuan Hang 
Published: April 2024

Abstract

When using pile composite foundation reinforcement for embankments in soft foundation sections, the embankment is prone to differential settlement, sliding, and even collapse. Based on the failure characteristics of pile composite foundation, this article proposes a reinforcement scheme using 'inclined-straight double-row piles' at the toe of the embankment slope. Through model tests, the deformation process, bending moment, and horizontal displacement of the pile body under lateral loading were compared for multiple sets of 'inclined-straight double-row piles'. Combined with numerical simulation analysis, the load-deformation characteristics and failure modes of the inclined-straight double-row piles under lateral loading were revealed, and a calculation analysis model was proposed to provide reference for the practical engineering application. The following conclusions were mainly drawn: (1) Under lateral loading, the inclined-straight double-row piles experience horizontal displacement, followed by bending deformation, with the inner piles failing first and the outer piles failing later, showing correlation. The failure load of the double straight piles falls between the inner and outer piles of the inclined-straight double-row piles. Increasing the bending stiffness of the inner piles and the inclination of the outer piles will significantly improve the overall stability. (2) When subjected to lateral loading, the inclined-straight double-row piles may experience overturning failure due to excessive lateral movement of the pile body or fracture failure due to excessive load on the pile body. (3) Calculation analysis models were developed for the overturning failure mode and pile body fracture failure mode.
Analysis of the synergistic benefits of typical technologies for pollution reduction and carbon reduction in the iron and steel industry in the Beijing-Tianjin-Hebei region
Authors: Wen Wei , Deng Zifan , Ma Xin , Xing Yi , Pan Chongchao , Liu Yusong , Tharaka W.A.N.D. , Hua Tongxin , Shen Liyao 
Published: April 2024

Abstract

With its high energy consumption and pollutant emissions, the iron and steel industry is a significant source of air pollution and carbon emissions in the Beijing-Tianjin-Hebei (BTH) region. To improve air quality and reduce greenhouse gas emissions, a series of policies involving ultra-low emission, synergistic reduction of pollution, and carbon application have been implemented in the region. Based on a co-control effects coordinate system, marginal abatement cost curve, and numerical modeling, this study assesses air pollutant and CO2 emission characteristics in the iron and steel industry of the region, along with the synergistic benefits of typical technologies. The results showed that: (1) Due to the large number of iron and steel enterprises and production in Tangshan and Handan, emissions in those two places were high. The sintering process is the main source of SO2, NOx, PM2.5, and CO, accounting for 64.86%, 55.15%, 29.98%, and 46.43% of the total emissions, respectively. (2) Among the typical measures, industrial restructuring and adjustment of the energy-resource structure had the highest emission reduction effect. High emission reduction potential and low-cost technologies such as TRT need to be promoted. (3) In the highest steel production city, Tangshan, the contribution of iron and steel to PM2.5, SO2, and NO2 was 30.51%, 50.67%, and 42.54% during the non-heating period. During the heating period, pollutants emitted from the combustion of fossil energy for heating increased, while iron and steel emissions decreased to 23.7%, 34.32%, and 29.13%. By 2030, after implementing ultra-low emission policies and typical synergistic reduction technologies, the contribution of the iron and steel industry to air quality significantly decreased.
Outcome of whole brain irradiation with a dose-escalated simultaneous-integrated boost in patients with multiple large and/or diffuse brain metastases: real live data and review of the literature
Authors: Agolli Linda , Nicosia Luca , Hilger Thomas , Iancu Gheorghe , Exeli Ann-Katrin , Eul Bastian , Struffert Tobias , Acker Till , Habermehl Daniel 
Published: April 2024

Abstract
Background: We retrospectively investigate feasibility and safety of whole brain radiotherapy (WBRT) including a simultaneous-integrated boost technique (WBRT-SIB) in a cohort of patients with a very poor prognosis suffering from multiple and/or large brain metastases, unfavorable primary histology, poor performance status and/or symptomatic BMs.
Materials and Methods: Thirty-five patients with high brain tumor burden, extracranial metastases and low life-expectancy were treated with WBRT-SIB mostly with 35-42Gy/14 fractions. All metastases were boosted in patients with up to 12 BMs. Otherwise, in patients with >12 BMs besides large BMs, also small metastases located in critical regions of the brain were irradiated with a SIB.
Results: The median number of BM was 8 (range 2-45) and the median BM diameter was 12 mm (range 4-90 mm). Fifteen (43%) patients had ≥10 BMs and 25 patients presented with a Karnofski index ≤ 80%. Primary tumor histology was NSCLC (n=13) and SCLC (n=11). The median iPFS was not reached, and 12- and 18-months iPFS were 75% and 50%, respectively. Overall, seven patients had intracranial progression: two patients within the SIB and WBRT area, one patient only within the SIB region and four patients had new BMs in the WBRT volume alone. The median iPFS for non-SCLC patients was 17 months and the 12- and 18-month iPFS were 56.8% and 28.4%, respectively. There was no significant OS difference between SCLC-group and non-SCLC patients (p=0.38). Overall, median OS was 8.7 months and 1-year OS was 25%. The treatment was generally well-tolerated with no observed cases of radionecrosis.
Conclusion: Our WBRT-SIB approach involves a combination of whole brain radiotherapy and a simultaneous integrated boost to specific tumor volumes, and its effectiveness is compared with other treatment modalities in the literature. Further research, including prospective studies with larger patient cohorts, is necessary to validate and refine the findings.
Hepatocyte-specific GDF15 overexpression improves high-fat diet-induced obesity and hepatic steatosis in mice via hepatic FGF21 induction
Authors: Takeuchi Kento , Yamaguchi Kanji , Takahashi Yusuke , Yano Kota , Okishio Shinya , Ishiba Hiroshi , Tochiki Nozomi , Kataoka Seita , Fujii Hideki , Seko Yuya , Umemura Atsushi , Moriguchi Michihisa , Okanoue Takeshi , Itoh Yoshito 
Published: April 2024

Abstract

GDF15 and FGF21, stress-responsive cytokines primarily secreted from liver, are promising therapeutic targets for metabolic dysfunction-associated steatotic liver disease (MASLD). However, the interaction between GDF15 and FGF21 remains unclear. We examined the effect of the hepatocyte-specific GDF15 or FGF21 overexpression in high-fat diet (HFD)-fed mice for 8 weeks. Hydrodynamic injection of GDF15 or FGF21 sustained high circulating levels of GDF15 or FGF21 respectively, resulting in marked reductions in body weight, epididymal fat mass, insulin resistance, and hepatic steatosis. Interestingly, GDF15 treatment led to early reduction in body weight despite no change in food intake, indicating the role of GDF15 other than appetite loss. GDF15 treatment increased liver-derived serum FGF21 levels, but FGF21 treatment did not affect GDF15 expression. GDF15 promoted eIF2α phosphorylation and splicing of XBP1s, leading to FGF21 induction. In murine AML12 hepatocytes treated with free fatty acids, GDF15 overexpression also upregulated Fgf21 mRNA levels and promoted eIF2α phosphorylation and XBP1 splicing. Taken together, excess FFAs flooding the liver resulted in a gradual increase of β-oxidation-derived reactive oxygen species and ER stress, suggesting that GDF15 enhanced this pathway and induced the expression of FGF21. The GDF15- and FGF21-related crosstalk is an important pathway for the treatment of MASLD.