bluuebunny/crossref_metadata_2025_split huggingface dataset:
A consensus statement on minimum operational standards for geriatric emergency care in Belgium: a modified Delphi study
Authors: Heeren Pieter , Islam Farah , Desruelles Didier , Flamaing Johan , Sabbe Marc , Milisen Koen ,   the Belgian URGENT Delphi Group, Heerinckx Philippe , Hubloue Ives , Tran Tuan Long , Wynants Stefan , Ghekière Veronique , De Brauwer Isabelle , Beernaert Laetitia , Cristelbach Sophie , Guldemont Sven , Lumen Dieter , Sohet Sebastien , Bogaerts Emilie , Himschoot Nadja , Michaux Nicole , Dath Mayelise , Biets Robin , Piron Cecile , Van den Heede Koen , Vande Voorde Carine , Ricour Celine 
Published: November 2023

Abstract
Background
As emergency department (ED) leaders started integrating geriatric emergency guidelines on a facultative basis, important variations have emerged between EDs in care for older patients. The aim of this study was to establish a consensus on minimum operational standards for Geriatric ED care in Belgium.

Methods
A two-stage modified Delphi study was conducted. Twenty panellists were recruited from Dutch and French speaking regions in Belgium to join an interdisciplinary expert panel. In the first stage, an online survey was conducted to identify and define all possible elements of geriatric emergency care. In the second stage, an online survey and online expert panel meeting were organized consecutively to determine which elements should be recognized as minimum operational standards.

Results
Between March 2020 and February 2021, the expert panel developed a broad consensus including ten statements focusing on the target population, specific goals, availability of geriatric practitioners and quality assurance. Additionally, the expert panel also determined which protocols, materials and accommodation criteria should be available in conventional EDs (39 standards) and in observational EDs (57 standards).

Conclusions
This study presents a consensus on minimum operational standards for geriatric emergency care in two ED types: the conventional ED and the observational ED. These findings may serve as a starting point towards broadly supported minimum standards of care stipulated by legislation in Belgium or other countries.
Plasma acylcarnitine in elderly Taiwanese: as biomarkers of possible sarcopenia and sarcopenia
Authors: Lo Chi-Jen , Lin Chih-Ming , Fan Chun-Ming , Tang Hsiang-Yu , Liu Han-Fang , Ho Hung-Yao , Cheng Mei-Ling 
Published: November 2023

Abstract
Background
Sarcopenia is defined as the disease of muscle loss and dysfunction. The prevalence of sarcopenia is strongly age-dependent. It could bring about disability, hospitalization, and mortality. The purpose of this study was to identify plasma metabolites associated with possible sarcopenia and muscle function to improve disease monitoring and understand the mechanism of muscle strength and function decline.

Methods
The participants were a group of healthy older adult who live in retirement homes in Asia (Taiwan) and can manage their daily lives without assistance. The participants were enrolled and divided into four groups: control (Con, n = 57); low physical function (LPF, n = 104); sarcopenia (S, n = 63); and severe sarcopenia (SS, n = 65) according to Asian countries that used Asian Working Group for Sarcopenia (AWGS) criteria. The plasma metabolites were used and the results were calculated as the difference between the control and other groups.

Results
Clinical parameters, age, gender, body mass index (BMI), hand grip strength (HGS), gait speed (GS), blood urea nitrogen (BUN), hemoglobin, and hematocrit were significantly different between the control and LPF groups. Metabolite patterns of LPF, S, and SS were explored in our study. Plasma kynurenine (KYN) and acylcarnitines (C0, C4, C6, and C18:1-OH) were identified with higher concentrations in older Taiwanese adults with possible sarcopenia and S compared to the Con group. After multivariable adjustment, the data indicate that age, BMI, and butyrylcarnitine (C4) are more important factors to identify individuals with low physical function and sarcopenia.

Conclusion
This metabolomic study raises the importance of acylcarnitines on muscle mass and function. It suggests that age, BMI, BUN, KYN, and C4/Cr can be important evaluation markers for LPF (AUC: 0.766), S (AUC: 0.787), and SS (AUC: 0.919).
Feasibility of Symptom monitoring WIth Feedback Trial (SWIFT) for adults on hemodialysis: a registry-based cluster randomized pilot trial
Authors: Agarwal Neeru , Shah Karan K. , Dansie Kathryn , Bennett Paul N. , Greenham Lavern , Brown Chris , Smyth Brendan , McDonald Stephen , Jesudason Shilpanjali , Viecelli Andrea K. , Morton Rachael L. ,   on behalf of the Symptom monitoring With Feedback Trial (SWIFT) Investigators, Hawley Carmel , Johnson David W. , Harris David , Laranjo Lilliana , Couchoud Cecile , Caskey Fergus J. , Palmer Suetonia , Jose Matthew , Simes R. John , Manns Braden , Handke William , Coiera Enrico , Mister Rebecca , Westall Portia 
Published: November 2023

Abstract
Background
Patients with kidney failure on hemodialysis (HD) experience considerable symptom burden and poor health-related quality of life (HRQoL). There is limited use of patient reported outcome measures (PROMs) in facility HD units to direct immediate care, with response rates in other studies between 36 to 70%. The aim of this pilot study was to evaluate feasibility of electronic PROMs (e-PROMs) in HD participants, with feedback 3-monthly to the participants’ treating team, for severe or worsening symptoms as identified by the Integrated Palliative Outcome Scale (IPOS-Renal), with linkage to the Australian and New Zealand Dialysis and Transplant (ANZDATA) registry, compared with usual care.

Methods
This is a registry-based cluster-randomized controlled pilot trial involving all adults receiving HD in 4 satellite units in Australia over a 6-month period. HD units were cluster randomized 1:1 to the control (HRQoL data collection only) or intervention arm (symptom monitoring with feedback to treating team every 3 months). Feasibility was assessed by participant response rate (percentage of eligible HD participants, including new incident participants, who completed the questionnaire at each time point); retention rate (percentage of participants who completed the baseline questionnaire and all subsequent measures); and completion time. HRQoL and symptom burden scores are described.

Results
There were 226 unique participants who completed the e-PROMs (mean age 62 years, 69% males, 78% White-European, median dialysis vintage 1.62 years). At 6 months, response rate and retention rate for the intervention arm were 54% and 68%, respectively, and 89% and 97% in the control arm. Median time to complete IPOS-Renal was 6.6 min (5.3, 10.1) at 3 months, and when combined with the outcome measure (EQ-5D-5L), the median time was 9.4 min (6.9, 13.6) at 6 months.

Conclusions
Electronic symptom monitoring among HD participants with feedback to clinicians is feasible. Variations in response and retention rates could be potentially explained by the lengthier questionnaire, and higher frequency of data collection time points for participants in the intervention arm. A definitive national RCT is underway.

Trial registration
ACTRN12618001976279 (07/12/2018).
Impairments in sleep and brain molecular clearance in people with cognitive deterioration and biological evidence of AD: a report of four cases
Authors: Buongiorno Mariateresa , Granell Esther , Caruana Giovanni , Sansa Gemma , Vives-Gilabert Yolanda , Cullell Natalia , Molina-Seguin Jessica , Almeria Marta , Artero Cristina , Sánchez-Benavides Gonzalo , Ray Nicola J , Correa Sonia A.L. , Krupinski Jerzy 
Published: November 2023

Abstract
Background
Recent evidence suggests that the failure of the glymphatic system – the brain’s waste clearance system, which is active during sleep – plays a key role in the pathophysiology of Alzheimer’s Disease (AD). Glymphatic function can be investigated using serial MRIs after intrathecal gadobutrol injection. This technique can reveal the health of the glymphatic system, but has not yet been used in participants with cognitive impairment due to AD.

Case report
This report describes the sleep and gadobutrol tracer clearance patterns of four participants diagnosed with mild to moderate cognitive impairment with evidence of AD pathology (pathological levels of Ab and p-tau in cerebrospinal fluid). We performed polysomnography and MRI studies before tracer injection and MRI scans at 1.5-2 h, 5–6 h, and 48 h after injection. Despite participants reporting no sleep problems, polysomnography revealed that all participants had moderate to severe sleep disturbances, including reduced sleep efficiency during the study and obstructive sleep apnea. Severe side-effects related to tracer administration were observed, impeding the completion of the protocol in two participants. Participants who finished the protocol displayed delayed and persistent tracer enrichment in the cortex and white matter, even 48 h after injection. These outcomes have not been observed in previous studies in participants without AD.

Conclusion
The findings suggest that brains with sleep impairment and AD pathology have poor glymphatic function, and therefore cannot clear the contrast tracer efficiently. This is likely to have caused the severe side effects in our participants, that have not been reported in healthy individuals. Our results may therefore represent the only available data acquired with this technique in participants with AD pathology.
Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey
Authors: James Peter Bai , Yendewa George A , Bah Abdulai Jawo , Osborne Augustus , Kpagoi Satta Sylvia , Margao Emmanuel Kamanda , Kangbai Jia , Wardle Jon 
Published: November 2023

Abstract
Background
A nationwide assessment of the link between women’s empowerment and homebirth has not been fully examined in Sierra Leone. Our study examined the association between women’s empowerment and homebirth among childbearing women in Sierra Leone using the 2019 Sierra Leone Demographic Health Survey (2019 SLDHS) data.

Method
We used the individual file (IR) of the 2019 SLDHS dataset for our analysis. A total of 7377 women aged 15–49 years who gave birth in the five years preceding the survey were included. Outcome variable was “home birth of their last child among women in the five years preceding the 2019 SLDHS. Women’s empowerment parameters include women’s knowledge level, economic participation, decision-making ability and power to refuse the idea of intimate partner violence. We used the complex sample command on SPSS version 28 to conduct descriptive and multivariate logistic regression analyses.

Results
Three in every 20 women had home childbirth (n = 1177; 15.3%). Women with low [aOR 2.04; 95% CI 1.43–2.92] and medium [aOR 1.44; 95%CI 1.05–1.97] levels of knowledge had higher odds of giving birth at home compared to those with high levels of knowledge. Women who did not have power to refuse the idea of intimate partner violence against women were more likely to had given birth at home [aOR 1.38; 95% CI1.09-1.74]. In addition, women with no [aOR 2.71; 95% CI1.34-5.46) and less than four antenatal care visits [aOR 2.08; 95% CI:1.51–2.88] and for whom distance to a health facility was a major problem [aOR 1.95; 95% CI1.49-2.56] were more likely to have had a homebirth. However, no statistically significant association was observed between a women’s decision-making power and home birth [aOR 1.11; 95% CI 0.86–1.41].

Conclusion
Despite improvements in maternal health indicators, homebirth by unskilled birth attendants is still a public health concern in Sierra Leone. Women with low knowledge levels, who did not have power to refuse the idea of intimate partner violence against women, had less than four ANC visits and considered distance to a health facility as a major problem had higher odds of giving birth at home. Our findings reflect the need to empower women by improving their knowledge level through girl child and adult education, increasing media exposure, changing societal norms and unequal power relations that promote gender-based violence against women, and improving roads and transport infrastructure.
MicroRNA-21 promotes head and neck squamous cell carcinoma (HNSCC) induced transition of bone marrow mesenchymal stem cells to cancer-associated fibroblasts
Authors: Wang Hao , Zhou Zhengyu , Lin Wenchao , Qian Yechun , He Shifang , Wang Jun 
Published: November 2023

Abstract
Background
Most patients diagnosed with head and neck tumor will present with locally advanced disease, requiring multimodality therapy. Bone marrow-derived mesenchymal stromal cells (BMSCs) respond to a variety of tumor cell-derived signals, such as inflammatory cytokines and growth factors. As a result, the inflammatory tumor microenvironment may lead to the recruitment of BMSCs. Whether BMSCs in the tumor environment are more likely to promote tumor growth or tumor suppression is still controversial. We aimed to determine whether microRNA-21(miR-21) would play a vital role in HNSCC induced transition of human bone marrow mesenchymal stem cells (hBMSCs) to cancer-associated fibroblasts (CAFs).

Methods
In this study, we used electron microscope to observed exosomes collected from human tissue and two cell lines. We co-cultured hBMSCs with exosomes from FaDu and Cal-27 cells with miR-21 inhibited or not, then assessed cell cycle changes of hBMSCs with flow cytometry and determined expression level of α-SMA and FAP through qRT-PCR and Western blot.

Results
We observed an up-regulation of miR-21 expression in HNSCC tissue and FaDu and Cal-27 cells. Importantly, the exosomes derived from both cells induced CAFs-like characteristics in hBMSCs. while treatment with a miR-21 inhibitor effectively suppressed the transition of hBMSCs to CAFs and reversed the changes in the cell cycle distribution. This suggests that miR-21 plays a crucial role in facilitating the transition of hBMSCs to CAFs and modulating the cell cycle dynamics.

Conclusion
Our findings highlight the significance of miR-21 in mediating the communication between HNSCC cells and hBMSCs through exosomes, leading to the promotion of CAFs-like features and alterations in the cell cycle of hBMSCs.
Lactate receptor GPR81 drives breast cancer growth and invasiveness through regulation of ECM properties and Notch ligand DLL4
Authors: Lundø Kathrine , Dmytriyeva Oksana , Spøhr Louise , Goncalves-Alves Eliana , Yao Jiayi , Blasco Laia P. , Trauelsen Mette , Ponniah Muthulakshmi , Severin Marc , Sandelin Albin , Kveiborg Marie , Schwartz Thue W. , Pedersen Stine F. 
Published: November 2023

Abstract
Background
The lactate receptor GPR81 contributes to cancer development through unclear mechanisms. Here, we investigate the roles of GPR81 in three-dimensional (3D) and in vivo growth of breast cancer cells and study the molecular mechanisms involved.

Methods
GPR81 was stably knocked down (KD) in MCF-7 human breast cancer cells which were subjected to RNA-seq analysis, 3D growth, in situ- and immunofluorescence analyses, and cell viability- and motility assays, combined with KD of key GPR81-regulated genes. Key findings were additionally studied in other breast cancer cell lines and in mammary epithelial cells.

Results
GPR81 was upregulated in multiple human cancer types and further upregulated by extracellular lactate and 3D growth in breast cancer spheroids. GPR81 KD increased spheroid necrosis, reduced invasion and in vivo tumor growth, and altered expression of genes related to GO/KEGG terms extracellular matrix, cell adhesion, and Notch signaling. Single cell in situ analysis of MCF-7 cells revealed that several GPR81-regulated genes were upregulated in the same cell clusters. Notch signaling, particularly the Notch ligand Delta-like-4 (DLL4), was strikingly downregulated upon GPR81 KD, and DLL4 KD elicited spheroid necrosis and inhibited invasion in a manner similar to GPR81 KD.

Conclusions
GPR81 supports breast cancer aggressiveness, and in MCF-7 cells, this occurs at least in part via DLL4. Our findings reveal a new GPR81-driven mechanism in breast cancer and substantiate GPR81 as a promising treatment target.
A case report of pituitary neuroendocrine tumor manifesting as severe conjunctival chemosis
Authors: Yamamuro Shun , Yoshino Atsuo , Nishide Takuma , Negishi Hiroshi , Kumagawa Takahiro 
Published: November 2023

Abstract
Background
Conjunctival chemosis (CC) is an extremely rare symptom of pituitary neuroendocrine tumor (PitNET). We report an extremely rare case of PitNET manifesting as severe CC.

Case presentation
A 48-year-old male was admitted to our hospital with severe CC, proptosis, and ptosis of the right eye. Magnetic resonance imaging demonstrated the tumor mass invading the cavernous sinus (CS) with cystic lesion. The patient underwent emergent endoscopic transsphenoidal surgery, and the pathological diagnosis was PitNET. CC of the right eye remarkably improved after the surgery. Glucocorticoid therapy was performed for right oculomotor nerve palsy, which rapidly improved. The postoperative course was uneventful and the patient was discharged from our hospital without hormone replacement.

Conclusions
CC caused by CS invasion of PitNET can be cured by early surgical treatment. Therefore, PitNET is important to consider in the differential diagnosis of CC.
Epidemiology of asthma exacerbation in children before and after the COVID-19 pandemic: a retrospective study in Chengdu, China
Authors: Zhang Lei , Liu Hanmin , Ai Tao , Chen Zijin , Tang Wei , Hu Shuai , Hu Jie 
Published: November 2023

Abstract
Purpose
To examine the numbers and characteristics of children affected by asthma exacerbation in Chengdu, China, before and after the COVID-19 pandemic to inform efforts to manage childhood asthma in the post epidemic era.

Methods
Data were retrospectively collected from children admitted for asthma exacerbation to Chengdu Women and Children’s Central Hospital between January 2017 and December 2022. Rates of hospitalization, ages of the affected children, comorbidities and infections, and relationships between hospitalization and seasonal or environmental factors were examined before and after the epidemic.

Results
Fewer children were hospitalized for asthma exacerbation, yet more hospitalized children had severe exacerbation after the epidemic than before. Rates of hospitalization varied considerably with time of year, and the timing of peak hospitalizations differed before and after the epidemic. Only before the epidemic, rates of hospitalization for asthma exacerbation were positively correlated with humidity. Infants made up a smaller proportion of hospitalized children after the epidemic than before, with preschool children accounting for most hospitalizations after the epidemic. The proportion of children hospitalized for asthma exacerbation who also had pneumonia was significantly smaller after the epidemic than before. Conversely, the proportion of children hospitalized for asthma exacerbation who also had allergic diseases was significantly greater after the epidemic than before.

Conclusion
The epidemiology of asthma exacerbation in children changed after the epidemic. Future efforts to manage the condition in the paediatric population should focus on severe asthma exacerbation, prevention and management of allergic diseases, and the influence of meteorological and environmental factors.
Psychometric performance of EQ-5D-5L and SF-6DV2 in measuring health status of populations in Chinese university staff and students
Authors: Zhou Hui Jun , Zhang Aixue , Wei Jie , Wu Jing , Luo Nan , Wang Pei 
Published: November 2023

Abstract
Aims
To compare measurement properties of EQ-5D-5L and SF-6DV2 in university staff and students in China.

Methods
A total of 291 staff and 183 undergraduates or postgraduates completed the two instruments assigned in a random order. The health utility scores (HUS) of EQ-5D-5L and SF-6DV2 were calculated using the respective value sets for Chinese populations. The agreement of HUSs was examined using intraclass correlation coefficients (ICC) and Bland-Altman plot. Convergent validity of their HUSs and similar dimensions were assessed using Spearman’s correlation coefficient. Known-group validity of the HUSs and EQ-VAS score was assessed by comparing the scores of participants with and without three conditions (i.e., disease, symptom or discomfort, and injury), as well as number of any of the three conditions; their sensitivity was also compared.

Results
The ICCs between the two HUSs were 0.567 (staff) and 0.553 (students). Bland-Altman plot found that EQ-5D-5L HUSs were generally higher. Strong correlation was detected for two similar dimensions (pain/discomfort of EQ-5D-5L and pain of SF-6DV2; anxiety/depression of EQ-5D-5L and mental health of SF-6DV2) in both samples. The correlation between the two HUSs were strong (0.692 for staff and 0.703 for students), and were stronger than their correlations with EQ-VAS score. All the three scores could discriminate the difference in three known-groups (disease, symptom or discomfort, number of any of the three conditions). The two HUSs were more sensitive than EQ-VAS score; and either of them was not superior than the other.

Conclusions
Both EQ-5D-5L and SF-6DV2 HUSs have acceptable measurement properties (convergent validity, known-groups validity, sensitivity) in Chinese university staff and students. Nevetheless, only EQ-5D-5L (PD and AD) and SF-6DV2 (PN and MH) showed indicated good convergent validity as expected. Two types of HUSs cannot be used interchangeably, and each has its own advantages in sensitivity.
Survey the effectiveness of education based on message framing through mobile phone on women’s physical activity
Authors: Shakerinejad Ghodratollah , Baji Zahra , Tehrani Masoumeh , Jarvandi Farzaneh , Cheraghi Maria , Hatamzadeh Nasser 
Published: November 2023

Abstract
Background
Physical activity in female employees is a healthy behavior and increases strength, endurance, improves flexibility, improves the feeling of vitality and freshness, improves health, and ultimately increases life expectancy. Health messages are one of the most effective ways to engage people and motivate them to perform healthy behaviors. The purpose of this study was to the study of the effectiveness of education based on message framing through mobile phone (whatsapp) on the physical activity of women employees of universities and higher education institutions in Ahvaz city.

Method
In this interventional study, 90 of female employees of three universities and higher education institutions of Ahvaz city were selected by random sampling and randomly divided into three groups (30 participants) receiving gain framed messages, receiving loss framed messages and the control group. The tools of data collection were demographic information questionnaire and international physical activity questionnaire (IPAQ). The participants of the intervention groups received educational messages about physical activity behavior in two different gain and loss framed messages through whatsapp for one month. Data were collected from three groups at the beginning of the study, immediately and two months after the intervention, and were analyzed using SPSS version 26.

Results
The results showed that there was a significant increase in the average physical activity score after the intervention in two interventional groups. by comparing the increase of this score, 53% improvement in physical activity is observed in the gain message group and 15% in loss massage group but there was no significant increase in the control group.

Conclusion
The results of this study showed that the design and implementation of education programs based on message framing, especially gain framed messages through online education (Whatsapp) can improve and promote physical activity behavior in women employees.